J Trauma
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Comparative Study
Hepatic arterial embolization in the management of blunt hepatic trauma: indications and complications.
The objective was to clarify the role of hepatic arterial embolization (AE) in the management of blunt hepatic trauma. ⋯ AE is a key element in modern management of high-grade liver injuries. Two principal indications exist in the acute postinjury phase: primary hemostatic control in hemodynamically stable or stabilized patients with radiologic computed tomography evidence of active arterial bleeding and adjunctive hemostatic control in patients with uncontrolled suspected arterial bleeding despite emergency laparotomy. Successful management of injuries of grade III upward often entails a combined angiographic and surgical approach. Awareness of the ischemic complications due to angioembolization is important.
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Multicenter Study Comparative Study
Blunt traumatic occult pneumothorax: is observation safe?--results of a prospective, AAST multicenter study.
An occult pneumothorax (OPTX) is found incidentally in 2% to 10% of all blunt trauma patients. Indications for intervention remain controversial. We sought to determine which factors predicted failed observation in blunt trauma patients. ⋯ Most blunt trauma patients with OPTX can be carefully monitored without tube thoracostomy; however, OPTX progression and respiratory distress are independently associated with observation failure.