World Journal of Emergency Surgery

http://www.wjes.org/

List of Papers (Total 519)

Mass casualty incidents - time to engage

Mass casualty incident continues to overwhelm medical systems worldwide. Preparedness for an MCI is a crucial requisite for the injured better outcome. The World Society of Emergency Surgery initiated a survey in regard to its senior member's personal and institutional preparedness for MCI. The results here in presented indicate that WSES should engage in a formatted and structured ...

Plasma calprotectin level: usage in distinction of uncomplicated from complicated acute appendicitis

Background The aim of this study was to identify the diagnostic role of plasma calprotectin value for a distinction of presence acute appendicitis and the indifference of uncomplicated from complicated acute appendicitis. Methods Plasma calprotectin, white blood cell and C-reactive protein values of 89 patients, who have undergone laparoscopic appendectomy between January 2013 and ...

Association between increased blood interleukin-6 levels on emergency department arrival and prolonged length of intensive care unit stay for blunt trauma

Background Systemic immune response to injury plays a key role in the pathophysiological mechanism of blunt trauma. We tested the hypothesis that increased blood interleukin-6 (IL-6) levels of blunt trauma patients on emergency department (ED) arrival are associated with poor clinical outcomes, and investigated the utility of rapid measurement of the blood IL-6 level. Methods We ...

Diagnostic accuracy of oblique chest radiograph for occult pneumothorax: comparison with ultrasonography

Backgraound An occult pneumothorax is a pneumothorax that is not seen on a supine chest X-ray but is detected by computed tomography scanning. However, critical patients are difficult to transport to the computed tomography suite. We previously reported a method to detect occult pneumothorax using oblique chest radiography (OXR). Several authors have also reported that ...

Comparison of the results of laparoscopic appendectomies with application of different techniques for closure of the appendicular stump

Background Nowadays laparoscopy is used frequently not only in elective surgery but also in abdominal emergencies, including acute appendicitis. There are several techniques used to close the appendicular stump during laparoscopic appendectomy. The aim of the study was to present and compare the results of minimally invasive appendectomies performed with the use of endoscopic ...

Obese patients who fall have less injury severity but a longer hospital stay than normal-weight patients

Background The effects of obesity on injury severity and outcome have been studied in trauma patients but not in those who have experienced a fall. The aim of this study was to compare injury patterns, injury severities, mortality rates, and in-hospital or intensive care unit (ICU) length of stay (LOS) between obese and normal-weight patients following a fall. Methods Detailed data ...

Emergency General Surgery: evolution of a subspecialty by stealth

Background Emergency surgical patients account for around half of all NHS surgical workload and 80 % of surgical deaths. Few trainees opt to CCT in General Surgery, and there is no recognised subspecialty training program in Emergency General Surgery (EGS). Despite this lack of training and relevant assessment by examination, there appears to be an increasing number of EGS posts ...

Intraoperative diagnosis of solitary cecal diverticulum not requiring surgery: is appendectomy indicated?

Aim To compare experience with solitary cecal diverticulum (SCD) with literature on the indication for appendectomy in cases of solitary cecal diverticulitis. Methods We retrospectively reviewed all cases of SCD in our institution from September 2011 to March 2013. Data on sex, age, ethnic origin, presence of pain in the right iliac fossa, duration of symptoms, diagnosis, ...

Patient-reported health-related quality of life after a displaced intra-articular calcaneal fracture: a systematic review

Background A displaced intra-articular calcaneal fracture (DIACF) is known for having a negative influence on the daily activities of patients. A health-related quality of life (HRQoL) outcome instrument is used to quantify the impact of DIACF. It seems that these studies used restrictive inclusion criteria and observe specific patient groups; consequently, an increased risk of ...

Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections: a prospective multicentre study (WISS Study)

Background To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression. Methods The WISS study (WSES cIAIs Score ...

Acute appendicitis: proposal of a new comprehensive grading system based on clinical, imaging and laparoscopic findings

Advances in the technology and improved access to imaging modalities such as Computed Tomography and laparoscopy have changed the contemporary diagnostic and management of acute appendicitis. Complicated appendicitis (phlegmon, abscess and/ or diffuse peritonitis), is now reliably distinguished from uncomplicated cases. Therefore, a new comprehensive grading system for acute ...

Critically ill patients with acute cholecystitis are at increased risk for extensive gallbladder inflammation

Background Acute cholecystitis is a common diagnosis and surgery is the standard of care for young and fit patients. However, due to high risk of postoperative morbidity and mortality, surgical management of critically ill patients remains a controversy. It is not clear, whether the increased risk of perioperative complications associated with the management of critically ill ...

Intra-abdominal hypertension; prevalence, incidence and outcomes in a low resource setting; a prospective observational study

Background Intra-abdominal hypertension (IAH) is defined as a sustained elevation in intra-abdominal pressure (IAP) greater than or equal to 12 mmHg. IAH has been shown to cause organ derangements and dysfunction in the body. Objective screening of IAH is neither done early enough nor at all thus leading to significant morbidity and mortality among surgical patients. The ...

Massive hemothorax due to inferior phrenic artery injury after blunt trauma

Injury to the inferior phrenic artery after blunt trauma is an extremely rare event, and it may occur under unanticipated conditions. This case report describes an injury to the left inferior phrenic artery caused by blunt trauma, which was complicated by massive hemothorax, and treated with transcatheter arterial embolization (TAE). An 81 year-old female hit by a car while walking ...

Occult fractures of the proximal femur: imaging diagnosis and management of 82 cases in a regional trauma center

Background Occult hip fractures are often difficult to identify in busy trauma units. We aimed to present our institutions experience in the diagnosis and treatment of occult fractures around the hip and to help define a clinical and radiological management algorithm. Method We conducted a seven-year retrospective hospital medical record analysis. The electronic database was ...

The impact of early surgical intervention in free intestinal perforation: a time-to-intervention pilot study

Purposes An abdominal inflammatory focus is the second most often source of sepsis with a high risk of death in surgical intensive care units. By establishing evidence-based bundled strategies the surviving sepsis campaign provided an optimized rapid and continuous treatment of these emergency patients. Hereby the hospital mortality decreased from 35 to 30 %. Sepsis treatment is ...

Metallothionein ameliorates burn sepsis partly via activation of Akt signaling pathway in mice: a randomized animal study

Introduction Metallothioneins (MTs) are a family of cysteine-rich and low molecular-weight proteins that can regulate metal metabolism and act as antioxidants. Recent studies showed that MTs played a protective role in excessive inflammation and sepsis. However, the role of MTs in burn sepsis remains unclear. This study is designed to investigate the role of MTs in burn sepsis in ...

Gunshot wound without entrance hole: where is the trick? – a case report and review of the literaturer

The presence at CT scan of more retained bullets than expected could be a very difficult interpretation challenge in the early management of gunshot wounds. The modern non operative management of haemodinamically stable patients without peritonitis requires that the trajectory of the bullet is clearly recognized. This clinical case reporting of a gunshot wound without evident entry ...

Antibiotics alone versus appendectomy to treat uncomplicated acute appendicitis in adults: what do meta-analyses say?

Background Primary appendectomy is the current standard of care for treating uncomplicated acute appendicitis, but interest in conservative treatment with antibiotics alone has been increasing in recent years. Clinical trials so far have shown controversial results. Methods A series of meta-analyses were reviewed. Studies comparing surgery versus antibiotics alone for treating ...

Transcatheter thrombolysis combined with damage control surgery for treatment of acute mesenteric venous thrombosis associated with bowel necrosis: a retrospective study

Objective This study aims to evaluate the clinical outcomes of transcatheter thrombolysis in acute superior mesenteric venous thrombosis (ASMVT) associated with bowel necrosis. Methods A retrospective study of six patients with ASMVT treated with catheter-directed thrombectomy/thrombolysis and damage control surgery at Jinling Hospital (Nanjing, China) between 2010 and 2013 was ...

WSES position paper on vascular emergency surgery

Trauma, both blunt and penetrating, is extremely common worldwide, as trauma to major vessels. The management of these patients requires specialized surgical skills and techniques of the trauma surgeon. Furthermore few other surgical emergencies require immediate diagnosis and treatment like a ruptured abdominal aortic aneurysm (rAAA). Mortality of patients with a rAAA reaches ...

Caustic ingestion management: world society of emergency surgery preliminary survey of expert opinion

Caustic material ingestion injuries (CMI) are uncommon. Only 5,000 cases are reported in the United States each year and most acute care healthcare facilities admit only a few cases annually. Accordingly, no single institution can claim extensive experience, and management protocols are most probably based on either expert opinion or literature reports. In this study, we will ...

Etiology, treatment outcome and prognostic factors among patients with secondary peritonitis at Bugando Medical Centre, Mwanza, Tanzania

Introduction Secondary peritonitis due to perforation of the gastrointestinal tract is one of the most common surgical emergencies all over the world and is associated with significantly morbidity and mortality. Previous studies conducted at Bugando Medical Centre (BMC) were retrospective and each was focused on single etiology; therefore there was an obvious need to evaluate the ...

The importance of open emergency surgery in the treatment of acute mesenteric ischemia

Objective Acute mesenteric ischemia (AMI) is a complex disease with a high mortality rate. A patient’s chance of survival depends on early diagnosis and rapid revascularization to prevent progression of intestinal gangrene. We reviewed our experience with open surgery treatment in 54 cases of AMI. Methods A monocentric retrospective study was conducted between 01/01/2001 and ...

The limitations of using risk factors to screen for blunt cerebrovascular injuries: the harder you look, the more you find

Introduction Blunt cerebrovascular injury (BCVI) is reported to occur in 1–2 % of blunt trauma patients. Clinical and radiologic risk factors for BCVI have been described to help identify patients that require screening for these injuries. However, recent studies have suggested that BCVI frequently occurs even in the absence of these risk factors. The purpose of this study was to ...