Journal of Trauma and Injury

Penetrating gallbladder injury in a pediatric patient: a case report: Nelimar Cruz-Centeno, Shai Stewart, Derek R. Marlor, Charlene Dekonenko, Richard J. Hendrickson; J Trauma Inj. 2023;36(3):295-297. Published online July 5, 2023; DOI: https://doi.org/10.20408/jti.2023.0008

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Abstract PDF: Penetrating gallbladder injuries are uncommon in the pediatric population. The treatment varies according to the severity of the injury and the patient’s hemodynamics. We present the case of an 11-year-old male with an accidental pellet gunshot wound to the right upper abdomen that resulted in a grade III liver laceration and damage to the anterior gallbladder wall. The patient underwent laparoscopic cholecystectomy with drain placement. Postoperative radiography of the surgical specimen confirmed the presence of the pellet in the gallbladder. The patient recovered uneventfully and was discharged home on postoperative day 3. Laparoscopic cholecystectomy is a feasible treatment option for penetrating gallbladder injuries in hemodynamically stable patients.; Summary

Dual repair of traumatic flank hernia using laparoscopic and open approaches: a case report: Yoonjung Heo, Dong Hun Kim; J Trauma Inj. 2022;35(1):46-50. Published online October 25, 2021; DOI: https://doi.org/10.20408/jti.2021.0008

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Abstract PDF Supplementary Material: Traumatic flank hernia (TFH) is rare and prone to recurrence, which makes appropriate treatment challenging. No current guidelines define the optimal timing and method of repair. Meanwhile, recent advances in laparoscopic techniques are reshaping the options for the treatment of TFH. A dual approach that utilizes both laparoscopic and open methods has not previously been reported. Herein, we present the successful treatment of TFH after blunt trauma. A 46-year-old male patient underwent elective herniorrhaphy on hospital day 3, in which laparoscopic implantation of a sublay mesh and extracorporeal implantation of an onlay mesh were performed. Such techniques may be appropriate and result in feasible outcomes in hemodynamically stable patients with large TFH who are strongly suspected of having bowel herniation or concomitant intraperitoneal injuries. Larger studies are needed to assess the long-term results.; Summary

Diagnostic and Therapeutic Laparoscopy for Abdominal Trauma: A Single Surgeon’s Experience at a Level I Trauma Center: Hancheol Jo, Dong Hun Kim; J Trauma Inj. 2021;34(4):248-256. Published online March 15, 2021; DOI: https://doi.org/10.20408/jti.2020.0081

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Abstract PDF: Purpose
Laparoscopy has various advantages over laparotomy in terms of postoperative recovery. The number of surgeons using laparoscopy as a diagnostic and therapeutic tool in abdominal trauma patients is increasing, whereas open conversion is becoming less common. This report summarizes a single surgeon’s experience of laparoscopy at a level I trauma center and evaluates the feasibility of laparoscopy as a diagnostic and therapeutic tool for abdominal trauma patients.
Methods
In total, 30 abdominal trauma patients underwent laparoscopy by a single surgeon from October 2014 to May 2020. The purpose of laparoscopy was categorized as diagnostic or therapeutic. Patients were classified into three groups by type of surgery: total laparoscopic surgery (TLS), laparoscopy-assisted surgery (LAS), or open conversion (OC). Univariate analysis was performed to determine the advantages and disadvantages.
Results
The mechanism of injury was blunt in 19 (63.3%) and penetrating in 11 patients (36.7%). Eleven (36.7%) and 19 patients (63.3%) underwent diagnostic and therapeutic laparoscopy, respectively. The hospital stay was shorter for patients who underwent diagnostic laparoscopy than for those who underwent therapeutic laparoscopy (5.0 days vs. 13.0 days), but no other surgical outcomes differed between the groups. TLS, LAS, and OC were performed in 12 (52.2%), eight (34.8%), and three patients (13.0%), respectively. There was no significant difference in morbidity and mortality among the three groups.
Conclusions
Laparoscopic surgery for selected cases of abdominal trauma may be feasible and safe as a diagnostic and therapeutic tool in hemodynamically stable patients due to the low OC rate and the absence of fatal morbidity and mortality.; Summary

Laparoscopy in Blunt Abdominal Trauma: Diaphragmatic and Bladder Lacerations Repair: Ruben Martins, Martins dos Santos, Tatiana Revez; J Trauma Inj. 2019;32(3):176-180. Published online September 30, 2019; DOI: https://doi.org/10.20408/jti.2019.019

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Abstract PDF: The growing use of laparoscopy in elective surgery has led to its increase utilization in emergency surgery. However, the employment of laparoscopy in abdominal trauma is still unusual. Here in we report a case of a patient with blunt abdominal trauma that resulted in a combination of exceptional traumatic lesions, diaphragmatic and bladder lacerations. Both injuries were diagnosed and successfully resolved by laparoscopy. The report of this type of lesions and resolution is extremely rare, being this the second case described in the international literature. This article intends to show that laparoscopy may not only be used as a diagnostic tool, but also as a therapeutic instrument in selected cases of blunt abdominal trauma.; Summary

Diagnostic Laparoscopy and Laparoscopic Diverting Sigmoid Loop Colostomy in Penetrating Extraperitoneal Rectal Injury: A Case Report: Young Goun Jo, Yun Chul Park, Wu Seong Kang, Jung Chul Kim, Chan Yong Park; J Trauma Inj. 2017;30(4):216-219. Published online December 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.4.216

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Abstract PDF

Laparoscopy has been one of the most effective modalities in various surgical situations, although its use in trauma patients has some limitations. The benefits of laparoscopy include cost-effectiveness, shorter length of hospital stay, and less postoperative pain. This report describes diagnostic laparoscopy and laparoscopic diverting sigmoid loop colostomy in penetrating extraperitoneal rectal injury. A 41-year-old male presented with perineal pain following penetrating trauma caused by a tree limb. Computed tomography showed air density in the perirectal space and retroperitoneum. As his vital signs were stable, we performed diagnostic laparoscopy and confirmed no intraperitoneal perforation. Therefore, laparoscopic diverting sigmoid loop colostomy was performed. He was discharged without any complications despite underlying hepatitis C-related cirrhosis. Colostomy closure was performed 3 months later.

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Citations

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The floating rectum
Sean Ng Kwet Chi Ng Ying Kin, William Jiang, Asiri Arachchi, Hanumant Chouhan
ANZ Journal of Surgery.2022; 92(1-2): 264. CrossRef

Traumatic Abdominal Wall Hernia: A Case Report: Youngro Yang, Kwangsig Kim; J Trauma Inj. 2017;30(2):70-73. Published online June 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.2.70

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Abstract PDF

Traumatic abdominal wall hernia is a rare condition that can follow any blunt trauma to the abdomen. Generally there has been an increase in the incidence of blunt abdominal trauma, although the case of traumatic abdominal wall hernias are rare. Probably due to the elasticity of the abdominal wall for resisting the shear forces generated by a traumatic impacts. In this case, we are reporting 1 rare case, diagnosed as an abdominal wall hernia associated with herniation of bowel loops due to blunt trauma without intra-abdominal injury including peritoneum.

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Traumatic abdominal wall hernia: a rare and often missed diagnosis in blunt trauma
Sohil Pothiawala, Sunder Balasubramaniam, Mujeeb Taib, Savitha Bhagvan
World Journal of Emergency Medicine.2022; 13(6): 492. CrossRef

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