J Trauma
-
Review Case Reports
Splenic artery embolization for post-traumatic splenic artery pseudoaneurysm in children.
Although rare, traumatic splenic artery pseudoaneurysm (SAP) can be life threatening. The diagnostic approaches as well as the methods of treatment of SAP are yet to be determined. We present the case of a 10-year-old boy treated conservatively for a grade III blunt splenic injury (BSI). ⋯ Abdominal pain was the most frequent symptom of SAP, but three children were asymptomatic at the time of diagnosis. Therefore, the possibility of SAP should be investigated even in the asymptomatic child with mild splenic injury. When a splenic pseudoaneurysm is diagnosed, we believe splenic artery embolization is indicated.
-
Comparative Study
Goal-directed ultrasound in the detection of long-bone fractures.
New portable ultrasound (US) systems are capable of detecting fractures in the remote setting. However, the accuracy of ultrasound by physicians with minimal ultrasound training is unknown. ⋯ Ultrasound scans by minimally trained clinicians may be used to rule out a long-bone fracture in patients with a medium to low probability of fracture.
-
Comparative Study
Hand-held thoracic sonography for detecting post-traumatic pneumothoraces: the Extended Focused Assessment with Sonography for Trauma (EFAST).
Thoracic ultrasound (EFAST) has shown promise in inferring the presence of post-traumatic pneumothoraces (PTXs) and may have a particular value in identifying occult pneumothoraces (OPTXs) missed by the AP supine chest radiograph (CXR). However, the diagnostic utility of hand-held US has not been previously evaluated in this role. ⋯ EFAST has comparable specificity to CXR but is more sensitive for the detection of OPTXs after trauma. Positive EFAST findings should be addressed either clinically or with CT depending on hemodynamic stability. CT should be used if detection of all PTXs is desired.
-
To facilitate the identification of ED patients at risk for intimate partner violence (IPV), we assessed the relationship of acute violence-related injury and history of IPV victimization or perpetration. ⋯ Screening for IPV among individuals presenting with a violence-related injury may be helpful in identifying individuals at risk of partner violence.
-
CT scans are often used in the evaluation of blunt trauma patients. Many scans are negative. Clinical predictors of positive abdominal CT scans would be beneficial in patient care. ⋯ Our data suggest that an abnormal pelvis x-ray and intubation are significant risk factors for a positive CT scan. Alcohol intoxication, mechanism of injury, and unreliable examination, without other associated indication for a scan, may warrant further study.