World Journal of Emergency Surgery

http://www.wjes.org/

List of Papers (Total 529)

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...

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 85...

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 04...

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...

Foregut caustic injuries: results of the world society of emergency surgery consensus conference

Introduction Lesions of the upper digestive tract due to ingestion of caustic agents still represent a major medical and surgical emergency worldwide. The work-up of these patients is poorly defined and no clear therapeutic guidelines are available. Purpose of the study The aim of this study was to provide an evidence-based international consensus on primary and secondary...

Evaluation of clotting factor activities early after severe multiple trauma and their correlation with coagulation tests and clinical data

Introduction Traumatic injuries are amongst the leading causes of death worldwide, frequently as a result of uncontrolled hemorrhage. Critical deficiencies in clotting factors have been noted in trauma-induced coagulopathy. However, the exact underlying conditions that result in devastating coagulopathies remain unclear. The purpose of this study was to elucidate these underlying...

Epidemiology and socioeconomic features of appendicitis in Taiwan: a 12-year population-based study

Introduction This paper presents an epidemiologic study of appendicitis in Taiwan over a twelve-year period. An analysis of the incidence in the low-income population (LIP) is included to explore the effects of lower socioeconomic status on appendicitis. Methods We analyzed the epidemiological features of appendicitis in Taiwan using data from the National Health Insurance...

Liver trauma: WSES position paper

The liver is the most injured organ in abdominal trauma. Road traffic crashes and antisocial, violent behavior account for the majority of liver injuries. The present position paper represents the position of the World Society of Emergency Surgery (WSES) about the management of liver injuries.

WSES guidelines for management of Clostridium difficile infection in surgical patients

In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary...

IROA: the International Register of Open Abdomen.: An international effort to better understand the open abdomen: call for participants

Actually the most common indications for Open Abdomen (OA) are trauma, abdominal sepsis, severe acute pancreatitis and more in general all those situations in which an intra-abdominal hypertension condition is present, in order to prevent the development of an abdominal compartment syndrome. The mortality and morbidity rate in patients undergone to OA procedures is still high. At...

Trauma resuscitation requiring massive transfusion: a descriptive analysis of the role of ratio and time

Objective We aimed to evaluate whether early administration of high plasma to red blood cells ratios influences outcomes in injured patients who received massive transfusion protocol (MTP). Methods A retrospective analysis was conducted at the only level 1 national trauma center in Qatar for all adult patients(≥18 years old) who received MTP (≥10 units) of packed red blood cell...

The role of the open abdomen procedure in managing severe abdominal sepsis: WSES position paper

The open abdomen (OA) procedure is a significant surgical advance, as part of damage control techniques in severe abdominal trauma. Its application can be adapted to the advantage of patients with severe abdominal sepsis, however its precise role in these patients is still not clear. In severe abdominal sepsis the OA may allow early identification and draining of any residual...

Surgical management of AAST grades III-V hepatic trauma by Damage control surgery with perihepatic packing and Definitive hepatic repair–single centre experience

Background Severe liver injury in trauma patients still accounts for significant morbidity and mortality. Operative techniques in liver trauma are some of the most challenging. They include the broad and complex area, from damage control to liver resection. Material and method This is a retrospective study of 121 trauma patients with hepatic trauma American Association for...

The selection of diagnostic modalities in the management of pelvic fracture patients requiring transfers

Introduction Pelvic fractures can result in life-threatening hemorrhages. Therefore, pelvic fracture patients must usually be transferred to a trauma center for additional management. We attempted to analyze transferred pelvic fracture patients to determine which diagnostic modalities to use in different treatment settings. Materials and methods From May 1, 2008, to February 28...

The open abdomen, indications, management and definitive closure

The indications for Open Abdomen (OA) are generally all those situations in which is ongoing the development an intra-abdominal hypertension condition (IAH), in order to prevent the development of abdominal compartmental syndrome (ACS). In fact all those involved in care of a critically ill patient should in the first instance think how to prevent IAH and ACS. In case of ACS goal...

Severe mutilating injuries with complex macroamputations of the upper extremity – is it worth the effort?

Introduction An amputation of the upper extremity and the following replantation is still one of the most challenging operations in the field of reconstructive surgery, especially in extremely severe cases of combined mutilating macroamputations including avulsion and multilevel injuries. Specialists agree that macroamputations with sharp wound edges are an absolute indication...

Maxillofacial and neck trauma: a damage control approach

Severe maxillofacial and neck trauma exposes patients to life threatening complications such as airway compromise and hemorrhagic shock. These conditions require rapid actions (diagnosis and management) and a strong interplay between surgeons and anesthesiologists. Effective airway management often makes the difference between life and death in severe maxillofacial and neck...

Inferior vena cava enteric fistula due to unresected colorectal metastasis

A 57 year old male presented to our department with recurrent attacks of sepsis and upper gastrointestinal bleeding due to colorectal cancer metastasis that resulted in a fistula involving the inferior vena cava and the third part of the duodenum. Four and a half years ago he underwent laparoscopic right hemicolectomy due to colonic adenocarcinoma. A year prior to his recent...