Pub Date : 2023-07-31DOI: 10.17479/jacs.2023.13.2.66
A. Laosebikan, Y. Pillay
Small intestinal diverticula is a rare occurrence, and their surgical management remains controversial due to the lack of a recognized classification system. Complications such as perforation and obstruction are treated surgically. Their etiology remains nebulous but theories such as damage to the Auerbach’s nerve plexus have been advanced as a possible cause. The concomitant presence of a sigmoid intussusception due to diverticular disease in the same patient is truly a rare occurrence. The vast majority of colonic intussusception is due to malignancy and a benign etiology remains elusive. The reported cases of benign causes include a lipoma and benign lymphadenopathy. We believe this to be the first such case report of a colonic diverticulum causing an intussusception. Despite an exploratory laparotomy of less than sixty minutes, the patient demised in the intensive care unit following an occipital lobe stroke. We believe this case of sigmoid intussusception with concomitant small intestinal diverticula to be the first such case report of its kind in English-language scientific publications.
{"title":"A Rare Case of Sigmoid Intussusception due to Sigmoid Diverticula in a Patient with Concomitant Extensive Small Bowel Diverticula","authors":"A. Laosebikan, Y. Pillay","doi":"10.17479/jacs.2023.13.2.66","DOIUrl":"https://doi.org/10.17479/jacs.2023.13.2.66","url":null,"abstract":"Small intestinal diverticula is a rare occurrence, and their surgical management remains controversial due to the lack of a recognized classification system. Complications such as perforation and obstruction are treated surgically. Their etiology remains nebulous but theories such as damage to the Auerbach’s nerve plexus have been advanced as a possible cause. The concomitant presence of a sigmoid intussusception due to diverticular disease in the same patient is truly a rare occurrence. The vast majority of colonic intussusception is due to malignancy and a benign etiology remains elusive. The reported cases of benign causes include a lipoma and benign lymphadenopathy. We believe this to be the first such case report of a colonic diverticulum causing an intussusception. Despite an exploratory laparotomy of less than sixty minutes, the patient demised in the intensive care unit following an occipital lobe stroke. We believe this case of sigmoid intussusception with concomitant small intestinal diverticula to be the first such case report of its kind in English-language scientific publications.","PeriodicalId":34662,"journal":{"name":"Journal of Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45819588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-31DOI: 10.17479/jacs.2023.13.2.70
Shouvik Das, A. Mandal, Ritesh Kumar, S. Chauhan, Krishna Rekha Mantry, S. Malik, S. Marwah
Fine needle aspiration (FNA) of the thyroid is a well-tolerated minimally invasive procedure. Thyroid abscess, as a complication of FNA in an immune-competent adult, is extremely rare. Diagnosis requires a high index of suspicion, for which treatment is intravenous antibiotics, drainage, and sometimes surgery. Here we present a case of thyroid abscess in an otherwise healthy man who presented with neck pain, rapidly increasing neck swelling, difficulty in swallowing, and hoarseness of the voice that developed two weeks after diagnostic FNA of a thyroid nodule which had been present for ten months. Despite antibiotic treatment, the abscess ruptured into the trachea, requiring surgical intervention. This highlights the importance of maintaining asepsis during FNA of the thyroid. Timely diagnosis of a thyroid abscess is essential to avoid life-threatening airway complications.
{"title":"Thyroid Abscess After Fine Needle Aspiration with Spontaneous Rupture into the Trachea : A Case Report","authors":"Shouvik Das, A. Mandal, Ritesh Kumar, S. Chauhan, Krishna Rekha Mantry, S. Malik, S. Marwah","doi":"10.17479/jacs.2023.13.2.70","DOIUrl":"https://doi.org/10.17479/jacs.2023.13.2.70","url":null,"abstract":"Fine needle aspiration (FNA) of the thyroid is a well-tolerated minimally invasive procedure. Thyroid abscess, as a complication of FNA in an immune-competent adult, is extremely rare. Diagnosis requires a high index of suspicion, for which treatment is intravenous antibiotics, drainage, and sometimes surgery. Here we present a case of thyroid abscess in an otherwise healthy man who presented with neck pain, rapidly increasing neck swelling, difficulty in swallowing, and hoarseness of the voice that developed two weeks after diagnostic FNA of a thyroid nodule which had been present for ten months. Despite antibiotic treatment, the abscess ruptured into the trachea, requiring surgical intervention. This highlights the importance of maintaining asepsis during FNA of the thyroid. Timely diagnosis of a thyroid abscess is essential to avoid life-threatening airway complications.","PeriodicalId":34662,"journal":{"name":"Journal of Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48989946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-31DOI: 10.17479/jacs.2023.13.2.58
K. Hirose, S. Murakami, Y. Kurashima, N. Sato, Saseem Poudel, Kimitaka Tanaka, A. Matsui, Y. Nakanishi, Toshimichi Asano, T. Noji, Y. Ebihara, Toru Nakamura, T. Tsuchikawa, T. Shichinohe, Kazufumi Okada, I. Yokota, Naoto Hasegawa, Satoshi Hirano
Purpose: General surgeons at regional hospitals should have the primary trauma care skills necessary to treat critically ill trauma patients to withstand transfer. This study was conducted to identify a consensus on primary trauma care skills for general surgeons.Methods: An initial list of acute care surgical skills was compiled, and revised by six trauma experts (acute care surgeons); 33 skills were nominated for inclusion in the Delphi consensus survey. Participants (councilors of the Japanese Society for Acute Care Surgery) were presented with the list of 33 trauma care skills and were asked (using web-based software) to rate how strongly they agreed or disagreed (using a 5-point Likert scale) with the necessity of each skill for a general surgeon. The reliability of consensus was predefined as Cronbach’s α ≥ 0.8, and trauma care skills were considered as primarily required when rated 4 (agree) or 5 (strongly agree) by ≥ 80% participants.Results: There were 117 trauma care specialists contacted to participate in the Delphi consensus survey panel. In the 1st round, 85 specialists participated (response rate: 72.6%). In the 2nd round, 66 specialists participated (response rate: 77.6%). Consensus was achieved after two rounds, reliability using Cronbach’s α was 0.94, and 34 items were identified as primary trauma care skills needed by general surgeons.Conclusion: A consensus-based list of trauma care skills required by general surgeons was developed. This list can facilitate the development of a new trauma training course which has been optimized for general surgeons.
{"title":"Delphi Method Consensus-Based Identification of Primary Trauma Care Skills Required for General Surgeons in Japan","authors":"K. Hirose, S. Murakami, Y. Kurashima, N. Sato, Saseem Poudel, Kimitaka Tanaka, A. Matsui, Y. Nakanishi, Toshimichi Asano, T. Noji, Y. Ebihara, Toru Nakamura, T. Tsuchikawa, T. Shichinohe, Kazufumi Okada, I. Yokota, Naoto Hasegawa, Satoshi Hirano","doi":"10.17479/jacs.2023.13.2.58","DOIUrl":"https://doi.org/10.17479/jacs.2023.13.2.58","url":null,"abstract":"Purpose: General surgeons at regional hospitals should have the primary trauma care skills necessary to treat critically ill trauma patients to withstand transfer. This study was conducted to identify a consensus on primary trauma care skills for general surgeons.Methods: An initial list of acute care surgical skills was compiled, and revised by six trauma experts (acute care surgeons); 33 skills were nominated for inclusion in the Delphi consensus survey. Participants (councilors of the Japanese Society for Acute Care Surgery) were presented with the list of 33 trauma care skills and were asked (using web-based software) to rate how strongly they agreed or disagreed (using a 5-point Likert scale) with the necessity of each skill for a general surgeon. The reliability of consensus was predefined as Cronbach’s α ≥ 0.8, and trauma care skills were considered as primarily required when rated 4 (agree) or 5 (strongly agree) by ≥ 80% participants.Results: There were 117 trauma care specialists contacted to participate in the Delphi consensus survey panel. In the 1st round, 85 specialists participated (response rate: 72.6%). In the 2nd round, 66 specialists participated (response rate: 77.6%). Consensus was achieved after two rounds, reliability using Cronbach’s α was 0.94, and 34 items were identified as primary trauma care skills needed by general surgeons.Conclusion: A consensus-based list of trauma care skills required by general surgeons was developed. This list can facilitate the development of a new trauma training course which has been optimized for general surgeons.","PeriodicalId":34662,"journal":{"name":"Journal of Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43366681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-31DOI: 10.17479/jacs.2023.13.2.47
Seung-yeon Lim, Young-min Jeong, So-young Jeong
Purpose: A retrospective descriptive study was performed to develop strategies to manage or prevent pressure ulcers in patients with severe trauma being cared for in the trauma intensive care unit (TICU).Methods: Study data was compiled from 315 patients with severe trauma (injury severity score ≥ 15) who were admitted to a general hospital from January 1, 2020, to February 28, 2021 and were being cared for in the TICU. For patients with pressure ulcers, the characteristics and associated factors of pressure ulcers were examined.Results: There were 42 severe trauma patients (13.3%) with pressure ulcers, of which, 50.0% of cases occurred at the site of the coccyx. In 50% of patients, Stage 2 pressure ulcers were observed. The mean onset day of pressure ulcers was 9.74 days after admission. The occurrence of diabetes, critical care triage score, length of stay in intensive care, death, shock, dialysis, ventilator application, endotracheal intubation, peripheral insertion central catheter insertion, A-line insertion, body protector application, sedatives, blood pressure boosters, nasal cannula, high-flow oxygenators, oxygen tip application, drainage insertion, nasogastric tube nutrition, and ventilator application period were investigated. Logistic regression analysis revealed that the influencing factors for the development of pressure ulcers were endotracheal intubation, length of stay in the TICU, and age, in that order.Conclusion: By identifying the characteristics and risk factors associated with pressure ulcers in patients with severe trauma, strategies can be developed to better prevent or manage pressure ulcers in the future.
{"title":"Characteristics and Risk Factors for Pressure Ulcers in Severe Trauma Patients Admitted to the Trauma Intensive Care Unit","authors":"Seung-yeon Lim, Young-min Jeong, So-young Jeong","doi":"10.17479/jacs.2023.13.2.47","DOIUrl":"https://doi.org/10.17479/jacs.2023.13.2.47","url":null,"abstract":"Purpose: A retrospective descriptive study was performed to develop strategies to manage or prevent pressure ulcers in patients with severe trauma being cared for in the trauma intensive care unit (TICU).Methods: Study data was compiled from 315 patients with severe trauma (injury severity score ≥ 15) who were admitted to a general hospital from January 1, 2020, to February 28, 2021 and were being cared for in the TICU. For patients with pressure ulcers, the characteristics and associated factors of pressure ulcers were examined.Results: There were 42 severe trauma patients (13.3%) with pressure ulcers, of which, 50.0% of cases occurred at the site of the coccyx. In 50% of patients, Stage 2 pressure ulcers were observed. The mean onset day of pressure ulcers was 9.74 days after admission. The occurrence of diabetes, critical care triage score, length of stay in intensive care, death, shock, dialysis, ventilator application, endotracheal intubation, peripheral insertion central catheter insertion, A-line insertion, body protector application, sedatives, blood pressure boosters, nasal cannula, high-flow oxygenators, oxygen tip application, drainage insertion, nasogastric tube nutrition, and ventilator application period were investigated. Logistic regression analysis revealed that the influencing factors for the development of pressure ulcers were endotracheal intubation, length of stay in the TICU, and age, in that order.Conclusion: By identifying the characteristics and risk factors associated with pressure ulcers in patients with severe trauma, strategies can be developed to better prevent or manage pressure ulcers in the future.","PeriodicalId":34662,"journal":{"name":"Journal of Acute Care Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48283307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-31DOI: 10.17479/jacs.2023.13.2.43
Younghwan Kim, S. Youn
Trauma surgeons' roles in a national hospital in Korea changed during the COVID-19 pandemic. In this study, we report on their roles over a 15-month period (March 2020 to May 2021) including the eight months where the hospital was a COVID-19-only hospital. Despite shortages in medical resources including medical personnel, and intensive care unit (ICU) beds, the trauma surgeons helped to control the public health problem by assuming various roles including working in another COVID-19 ICU in Dae-gu, treating trauma patients with COVID-19 or those who needed self-quarantine, being in charge of care for some COVID-19 patients in the ICU (for two months), and performing the role of a rapid response team member for COVID-19 ICU patients. In this report, we emphasize how trauma surgeons, along with intensivists, played an active role in treatment of COVID-19 patients, and helped prevent the collapse of the healthcare system within the hospital during the pandemic.
{"title":"The Activities and Roles of Trauma Surgeons in the Treatment of COVID-19 Patients","authors":"Younghwan Kim, S. Youn","doi":"10.17479/jacs.2023.13.2.43","DOIUrl":"https://doi.org/10.17479/jacs.2023.13.2.43","url":null,"abstract":"Trauma surgeons' roles in a national hospital in Korea changed during the COVID-19 pandemic. In this study, we report on their roles over a 15-month period (March 2020 to May 2021) including the eight months where the hospital was a COVID-19-only hospital. Despite shortages in medical resources including medical personnel, and intensive care unit (ICU) beds, the trauma surgeons helped to control the public health problem by assuming various roles including working in another COVID-19 ICU in Dae-gu, treating trauma patients with COVID-19 or those who needed self-quarantine, being in charge of care for some COVID-19 patients in the ICU (for two months), and performing the role of a rapid response team member for COVID-19 ICU patients. In this report, we emphasize how trauma surgeons, along with intensivists, played an active role in treatment of COVID-19 patients, and helped prevent the collapse of the healthcare system within the hospital during the pandemic.","PeriodicalId":34662,"journal":{"name":"Journal of Acute Care Surgery","volume":"29 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41271241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-03DOI: 10.5005/jp-journals-10089-0044
Garud S Chandan, Abhishek Samprathi
{"title":"A Pleural ‘Tamponade’!","authors":"Garud S Chandan, Abhishek Samprathi","doi":"10.5005/jp-journals-10089-0044","DOIUrl":"https://doi.org/10.5005/jp-journals-10089-0044","url":null,"abstract":"","PeriodicalId":34662,"journal":{"name":"Journal of Acute Care Surgery","volume":"136 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73225192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-03DOI: 10.5005/jp-journals-10089-0045
N. S. Moola, Ak Ajith Kumar, R. Deshpande, G. Madhu
{"title":"Alveolar Hemorrhage: A Rare Complication in Dengue","authors":"N. S. Moola, Ak Ajith Kumar, R. Deshpande, G. Madhu","doi":"10.5005/jp-journals-10089-0045","DOIUrl":"https://doi.org/10.5005/jp-journals-10089-0045","url":null,"abstract":"","PeriodicalId":34662,"journal":{"name":"Journal of Acute Care Surgery","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74975473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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