Indirect Colonic Injury After Military Wounding: A Case Series

Webster, Claire; Mercer, Stuart; Schrager, Jason; Carrell, Tom; Bowley, Douglas M.

doi:10.1097/ta.0b013e31822af672

Cited by 13 publications

(12 citation statements)

References 17 publications

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“…The effects of indirect injury from blast effects have been noted on several occasions, including blast lung injury, tympanic membrane damage, and even colonic injury, where one study found indirect damage to the colon by propagation of energy by the missile, remote from the track of the projectile. [11][12][13] With regards to blast effects in the head specifically, an 11-year, multi-institutional study of 720 patients with gunshot wounds and blast injuries to the face found high mortality and associated morbidity in these cases, with 26% of patients dying and 67% of patients hospitalized 448 h. 14 In 2015 Rex et al 15 noted that ocular injury is among the most common terrorist blast morbidities, arising in up to 28% of survivors, and yet the nature and extent of ocular injury from the primary blast itself, independent of flying debris, has been poorly explored. The study found that over the course of 1 month from exposure to blast injury, various forms of ocular damage arose from corneal edema to retinal detachment with associated vision loss.…”

Section: Discussionmentioning

confidence: 99%

Gun trauma and ophthalmic outcomes

Chopra

Gervasio

Kalosza

et al. 2017

Eye

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PurposeThis retrospective cohort study assesses the visual outcomes of patients who survive gunshot wounds to the head.MethodsThe Elmhurst City Hospital Trauma Registry and Mount Sinai Data Warehouse were queried for gun trauma resulting in ocular injury over a 16-year period. Thirty-one patients over 16 years of age were found who suffered a gunshot wound to the head and resultant ocular trauma: orbital fracture, ruptured globe, foreign body, or optic nerve injury. Gun types included all firearms and air guns. Nine patients were excluded due to incorrect coding or unavailable charts. Statistical analysis was performed using a simple bivariate analysis (χ).ResultsOf the 915 victims of gun trauma to the head, 27 (3.0%) sustained ocular injuries. Of the 22 patients whose records were accessible, 18 survived. Eight of the 18 surviving patients (44%) suffered long-term visual damage, defined as permanent loss of vision in at least one eye to the level of counting fingers or worse. Neither location of injury (P=0.243), nor type of gun used (P=0.296), nor cause of gun trauma (P=0.348) predicted visual loss outcome. The Glasgow Coma Scale eye response score on arrival to the hospital also did not predict visual loss outcome (P=0.793).ConclusionThere has been a dearth of research into gun trauma and even less research on the visual outcomes following gun trauma. Our study finds that survivors of gun trauma to the head suffer long-term visual damage 44% of the time after injury.

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Section: Discussionmentioning

confidence: 99%

Gun trauma and ophthalmic outcomes

Chopra

Gervasio

Kalosza

et al. 2017

Eye

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“…This may occasionally alert clinicians to unnoticed serious clincial events. 28,29 This approach also enabled auhtors to develop unique new management algorithms for treating rare serious conditions 30,31 . Furhtermore, a case series may have been collected over a specific period of time which should be mentioned in the paper.…”

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confidence: 99%

Clinical “case series”: a concept analysis

Fm¹,

Ak²,

Af³

2013

Af Hlth Sci

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Objectives: To analyze the concept of "case series" in the medical literature compared with case reports. Methods: A PubMed search for articles published during 2009 which had "case series" in their title was performed. A total number of 621 articles were retrieved. 586 papers were included in the analysis and 35 were excluded (18 were commentary letters, 5 were not in English, and twelve could not be retrieved by our Library). The number of patients and category of these articles were analyzed. Results: The median (range) of the number of cases of articles having "case series" in their title was 7 (1-6432) cases. 186/ 586 articles had less than 5 cases (31.7%, 95% CI (28.3-35.1%)). The median (range) of the number of cases of articles having "case report" as their publication type was 4 (1-178) cases. Out of the 219 articles categorized as case reports 114 (52.1%, 95% CI (45.6-58.6%)) had less than five cases. Conclusions: The concept of "case series" is not well defined in the literature and does not reflect a specific research design. We suggest that a case series should have more than four patients while four paitents or less should be reported individually as case reports.

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“…The papers reviewed emphasize how crucial the absence or the presence of shock and associated injuries is in the choice of surgical strategy. 2,4,7 In particular, hemorrhagic shock is the primary cause of shock in the battlefield and is also one of the causes of death found in the review. Therefore, future research could focus on the importance of medical evacuation and the treatment on the field to ensure hemodynamic stability until surgery can be performed.…”

Section: Discussionmentioning

confidence: 98%

Primary Repair or Fecal Diversion for Colorectal Injuries After Blast: A Medical Review

Bortolin

Baldari

Sabbadini

et al. 2014

Prehosp. Disaster med.

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Blast injury is a frequent cause of injury during armed conflicts, and the force of a blast can cause closed colorectal injury and perforation.1 After identification of a blast-related colorectal injury, the surgical options are primary repair or fecal diversion with the option for secondary repair. This structured review was conducted to determine which patients could be treated with primary repair (PR) or with fecal diversion. The review method followed the Prisma Statement method for medical systematic review. All data from the relevant articles were collected in a single database. Articles took into account wars in Bosnia, Iraq and Afghanistan from January 1993 through November 2012. The review was limited due to lack of reported data, hence qualitative analysis was the main review method. The review showed that for patients who do not have associated intra-abdominal injuries (diaphragm, stomach, pancreas, spleen, or kidney) or hemodynamic instability, PR did not result in an increase of complications or mortality.

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Indirect Colonic Injury After Military Wounding: A Case Series

Cited by 13 publications

References 17 publications

Gun trauma and ophthalmic outcomes

Gun trauma and ophthalmic outcomes

Clinical “case series”: a concept analysis

Primary Repair or Fecal Diversion for Colorectal Injuries After Blast: A Medical Review

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