49
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Kidney and uro-trauma: WSES-AAST guidelines

      review-article
      1 , , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 1 , 26 , 27 , 28 , 29 , 30 , 31 , WSES-AAST Expert Panel
      World Journal of Emergency Surgery : WJES
      BioMed Central
      Kidney, Urogenital, Urethra, Ureter, Bladder, Trauma, Adult, Pediatric, Classification, Guidelines, Embolization, Surgery, Operative, Non-operative, Conservative, Stenting, Urological, Endovascular trauma management, Flow chart

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Renal and urogenital injuries occur in approximately 10-20% of abdominal trauma in adults and children. Optimal management should take into consideration the anatomic injury, the hemodynamic status, and the associated injuries. The management of urogenital trauma aims to restore homeostasis and normal physiology especially in pediatric patients where non-operative management is considered the gold standard. As with all traumatic conditions, the management of urogenital trauma should be multidisciplinary including urologists, interventional radiologists, and trauma surgeons, as well as emergency and ICU physicians. The aim of this paper is to present the World Society of Emergency Surgery (WSES) and the American Association for the Surgery of Trauma (AAST) kidney and urogenital trauma management guidelines.

          Related collections

          Most cited references241

          • Record: found
          • Abstract: found
          • Article: not found

          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. Thoracic US examinations were performed during the initial resuscitation of injured patients at a provincial trauma referral center. A high frequency linear transducer and a 2.4 kg US attached to a video-recorder were used. Real-time EFAST examinations for PTXs were blindly compared with the subsequent results of CXRs, a composite standard (CXR, chest and abdominal CT scans, clinical course, and invasive interventions), and a CT gold standard (CT only). Charts were reviewed for in-hospital outcomes and follow-up. There were 225 eligible patients (207 blunt, 18 penetrating); 17 were excluded from the US examination because of battery failure or a lost probe. Sixty-five (65) PTXs were detected in 52 patients (22% of patients), 41 (63%) being occult to CXR in 33 patients (14.2% whole population, 24.6% of those with a CT). The US and CXR agreed in 186 (89.4%) of patients, EFAST was better in 16 (7.7%), and CXR better in 6 (2.9%). Compared with the composite standard, the sensitivity of EFAST was 58.9% with a likelihood ratio of a positive test (LR+) of 69.7 and a specificity of 99.1%. Comparing EFAST directly to CXR, by looking at each of 266 lung fields with the benefit of the CT gold standard, the EFAST showed higher sensitivity over CXR (48.8% versus 20.9%). Both exams had a very high specificity (99.6% and 98.7%), and very predictive LR+ (46.7 and 36.3). 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.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Splenic trauma: WSES classification and guidelines for adult and pediatric patients

            Spleen injuries are among the most frequent trauma-related injuries. At present, they are classified according to the anatomy of the injury. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic derangement, and the associated injuries. The management of splenic trauma patients aims to restore the homeostasis and the normal physiopathology especially considering the modern tools for bleeding management. Thus, the management of splenic trauma should be ultimately multidisciplinary and based on the physiology of the patient, the anatomy of the injury, and the associated lesions. Lastly, as the management of adults and children must be different, children should always be treated in dedicated pediatric trauma centers. In fact, the vast majority of pediatric patients with blunt splenic trauma can be managed non-operatively. This paper presents the World Society of Emergency Surgery (WSES) classification of splenic trauma and the management guidelines.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Etiology of urethral stricture disease in the 21st century.

              We determined the current etiology of urethral stricture disease in the developed world and whether there are any differences in etiology by patient age and stricture site. Between January 2001 and August 2007 we prospectively collected a database on 268 male patients with urethral stricture disease who underwent urethroplasty at a referral center. The database was analyzed for possible cause of stricture and for previous interventions. Subanalysis was done for stricture etiology by patient age and stricture site. The most important causes were idiopathy, transurethral resection, urethral catheterization, pelvic fracture and hypospadias surgery. Overall iatrogenic causes (transurethral resection, urethral catheterization, cystoscopy, prostatectomy, brachytherapy and hypospadias surgery) were the etiology in 45.5% of stricture cases. In patients younger than 45 years the main causes were idiopathy, hypospadias surgery and pelvic fracture. In patients older than 45 years the main causes were transurethral resection and idiopathy. In cases of penile urethra hypospadias surgery idiopathic stricture, urethral catheterization and lichen sclerosus were the main causes, while in the bulbar urethra idiopathic strictures were most prevalent, followed by strictures due to transurethral resection. The main cause of multifocal/panurethral anterior stricture disease was urethral catheterization, while pelvic fracture was the main cause of posterior urethral strictures. Of strictures treated with urethroplasty today iatrogenic causes account for about half of the urethral stricture cases in the developed world. In about 1 of 3 cases no obvious cause could be identified. The etiology is significantly different in younger vs older patients and among stricture sites.
                Bookmark

                Author and article information

                Contributors
                +39-050.992111 , federico.coccolini@gmail.com
                Ernest.Moore@dhha.org
                y_kluger@rambam.health.gov.il
                walt@biffl.com
                Ari.Leppaniemi@hus.fi
                yousuke_jpn4035@yahoo.co.jp
                Fernando.Kim@dhha.org
                peitzmanab@upmc.edu
                fragagp2008@gmail.com
                Massimo.sartelli@gmail.com
                Luca.ansaloni@auslromagna.it
                augustin.goran@gmail.com
                Andrew.Kirkpatrick@albertahealthservices.ca
                fabuzidan@uaeu.ac.ae
                imtazwani@gmail.com
                Dieter.Weber@health.wa.gov.au
                mpikoul@med.uoa.gr
                larream@infomed.sld.cu
                CArvieux@chu-grenoble.fr
                vassil.manchev@gmail.com
                vreva@mail.ru
                R.Coimbra@ruhealth.org
                docvladimir@yandex.by
                alainchichom@yahoo.com
                ordonezcarlosa@gmail.com
                massimo.chiarugi@med.unipi.it
                Fernando.Kim@dhha.org
                bsakakushev@gmail.com
                docjun0517@gmail.com
                ronmaier@uw.edu
                idicarlo@unict.it
                faustocatena@gmail.com
                Journal
                World J Emerg Surg
                World J Emerg Surg
                World Journal of Emergency Surgery : WJES
                BioMed Central (London )
                1749-7922
                2 December 2019
                2 December 2019
                2019
                : 14
                : 54
                Affiliations
                [1 ]ISNI 0000 0004 1756 8209, GRID grid.144189.1, General, Emergency and Trauma Surgery, , Pisa University Hospital, ; Via Paradisia, 56124 Pisa, Italy
                [2 ]ISNI 0000 0001 0369 638X, GRID grid.239638.5, Trauma Surgery, , Denver Health, ; Denver, CO USA
                [3 ]ISNI 0000 0000 9950 8111, GRID grid.413731.3, Division of General Surgery Rambam Health Care Campus, ; Haifa, Israel
                [4 ]ISNI 0000 0004 0449 3295, GRID grid.415402.6, Trauma Surgery Dept., , Scripps Memorial Hospital, ; La Jolla, California USA
                [5 ]General Surgery Dept., Mehilati Hospital, Helsinki, Finland
                [6 ]ISNI 0000 0004 0632 2959, GRID grid.411321.4, Department of Emergency and Critical Care Medicine, , Chiba University Hospital, ; Chiba, Japan
                [7 ]ISNI 0000000107903411, GRID grid.241116.1, Urology Department, , University of Colorado, ; Denver, USA
                [8 ]ISNI 0000 0004 1936 9000, GRID grid.21925.3d, Surgery Department, , University of Pittsburgh, ; Pittsburgh, PA USA
                [9 ]ISNI 0000 0001 0723 2494, GRID grid.411087.b, Trauma/Acute Care Surgery & Surgical Critical Care, , University of Campinas, ; Campinas, Brazil
                [10 ]General and Emergency Surgery, Macerata Hospital, Macerata, Italy
                [11 ]ISNI 0000 0004 1758 8744, GRID grid.414682.d, General, Emergency and Trauma Surgery Department, , Bufalini Hospital, ; Cesena, Italy
                [12 ]ISNI 0000 0001 0657 4636, GRID grid.4808.4, Department of Surgery, Zagreb University Hospital Centre and School of Medicine, , University of Zagreb, ; Zagreb, Croatia
                [13 ]ISNI 0000 0004 0469 2139, GRID grid.414959.4, General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, , Foothills Medical Centre, ; Calgary, Alberta Canada
                [14 ]ISNI 0000 0001 2193 6666, GRID grid.43519.3a, Department of Surgery, College of Medicine and Health Sciences, , UAE University, ; Al-Ain, United Arab Emirates
                [15 ]Department of Surgery, DHS Hospitals, Srinagar, Kashmir India
                [16 ]ISNI 0000 0004 0453 3875, GRID grid.416195.e, Department of General Surgery, , Royal Perth Hospital, ; Perth, Australia
                [17 ]ISNI 0000 0001 2155 0800, GRID grid.5216.0, 3rd Department of Surgery, Attiko Hospital, , National & Kapodistrian University of Athens, ; Athens, Greece
                [18 ]General Surgery, “General Calixto García”, Habana Medicine University, Havana, Cuba
                [19 ]GRID grid.450307.5, Clin. Univ. de Chirurgie Digestive et de l’Urgence, , CHUGA-CHU Grenoble Alpes UGA-Université Grenoble Alpes, ; Grenoble, France
                [20 ]General and Trauma Surgery Department, Pietermaritzburg Hospital, Pietermaritzburg, South Africa
                [21 ]General and Emergency Surgery, Sergei Kirov Military Academy, Saint Petersburg, Russia
                [22 ]ISNI 0000 0004 5946 0028, GRID grid.488519.9, Department of General Surgery, , Riverside University Health System Medical Center, ; Moreno Valley, CA USA
                [23 ]General Surgery Department, Mozir City Hospital, Mozir, Belarus
                [24 ]ISNI 0000 0001 2288 3199, GRID grid.29273.3d, Department of Surgery and Obstetrics and Gynecology, , University of Buea, ; Buea, Cameroon
                [25 ]GRID grid.477264.4, Trauma and Acute Care Surgery, , Fundacion Valle del Lili, ; Cali, Colombia
                [26 ]General and Emergency Surgery Department, Montevideo Hospital, Montevideo, Paraguay
                [27 ]General Surgery Department, Medical University, University Hospital St George, Plovdiv, Bulgaria
                [28 ]ISNI 0000 0004 0372 3116, GRID grid.412764.2, Department of Emergency and Critical Care Medicine, , Saint-Marianna University School of Medicine, ; Kawasaki, Japan
                [29 ]Department of Surgery, Harborview Medical Centre, Seattle, USA
                [30 ]ISNI 0000 0004 1757 1969, GRID grid.8158.4, Department of Surgical Sciences and Advanced Technologies “GF Ingrassia”, Cannizzaro Hospital, , University of Catania, ; Catania, Italy
                [31 ]Emergency and Trauma Surgery, Maggiore Hospital, Parma, Italy
                Article
                274
                10.1186/s13017-019-0274-x
                6886230
                31827593
                362690f9-153b-4155-b6b1-601dde241f47
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 10 September 2019
                : 23 October 2019
                Categories
                Review
                Custom metadata
                © The Author(s) 2019

                Surgery
                kidney,urogenital,urethra,ureter,bladder,trauma,adult,pediatric,classification,guidelines,embolization,surgery,operative,non-operative,conservative,stenting,urological,endovascular trauma management,flow chart

                Comments

                Comment on this article