Hollow Abdominal Organs Research Articles

Findings of Abdominal Imaging in Patients with COVID-19 - Part 1: Hollow Organs.

Since COVID-19 has spread worldwide, the role of imaging for early detection of the disease has become more prominent. Abdominal symptoms in COVID-19 are common in addition to respiratory manifestations. This review collected the available data about abdominal computed tomography (CT) and ultrasonography indications in hollow abdominal organs in patients with COVID-19 and their findings. Since abdominal imaging is less frequently used in COVID-19, there is limited information about the gastrointestinal findings. The most common indications for abdominal CT in patients with COVID-19 were abdominal pain and sepsis. Bowel wall thickening and fluid-filled colon were the most common findings in abdominal imaging. Acute mesenteric ischemia (AMI) was one of the COVID-19 presentations secondary to coagulation dysfunction. AMI manifests with sudden abdominal pain associated with high morbidity and mortality in admitted patients; therefore, CT angiography should be considered for early diagnosis of AMI. Ultrasonography is a practical modality because of its availability, safety, rapidity, and ability to be used at the bedside. Clinicians and radiologists should be alert to indications and findings of abdominal imaging modalities in COVID-19 to diagnose the disease and its potentially serious complications promptly.

Urgentna ultrasonografska dijagnostika akutnih traumatskih abdominalnih stanja - urgentni ultrazvuk u abdominalnoj traumi

Clearly defined protocols and multidisciplinary approach present a milestone for patients' condition evaluation. Ultrasound is a fast, accessible, non-invasive and repeatable radiological examination and has an important place in the trauma algorithms. It detects trauma of parenchymal and hollow abdominal organs, hematoperitoneum, and helps in the assessment of volume status. Ultrasound in trauma is performed according to the Focused Assessment with Sonography for the Trauma (FAST) protocol or as a standard ultrasonographic examination of the abdomen and can be repeated to monitor morphological changes due to indications for emergency surgical treatment.

Rates of success and failure of biopsies of hollow abdominal organs: descriptive analysis

Abstract Objective: To evaluate the rates of success and failure of ultrasound-guided percutaneous biopsy of lesions in hollow abdominal organs, as well as the influence of contrast enhancement on those rates. Materials and Methods: This was a retrospective, single-center study evaluating patients submitted to ultrasound-guided percutaneous biopsy of abdominal lesions in hollow organs between January 2017 and June 2018. Patient records were reviewed using a standardized data collection form. Results: We included 49 procedures performed in 48 patients, of whom 18 (38%) had a prior diagnosis of cancer. Malignancy was suspected in 44 cases (90%). Among those 44 cases, the suspicion was of a new neoplasm in 28 (64%), of relapse in 11 (25%), and of a metastatic lesion in 5 (11%). The histopathological findings were sufficient to make the diagnosis in all 44 of those cases, 33 (75%) of which were found to be malignant. The diagnosis was consistent with the clinical suspicion in 33 (75%) of the cases in which there was a definitive histological result. There were no complications resulting from the procedure. Conclusion: Ultrasound-guided percutaneous biopsy is a safe procedure that demonstrates high efficacy in providing a sufficient sample for the diagnosis. The main reason to perform such a biopsy is suspicion of a new neoplasm, followed by suspicion of a metastatic lesion. The histopathological results were concordant with the suspicion in the majority of the cases evaluated here.

Nature and etiology of hollow-organ abdominal injuries in frontal crashes

Injuries to the hollow organs of the lower digestive system carry substantial risk of complication due to infection and blood loss, and commonly require invasive abdominal surgery to diagnose and treat. The causes of, and risk factors for, lower abdomen injury in automobile collisions are poorly understood. The goal of this study was to investigate the risk factors and potential mechanisms of hollow-organ, lower abdomen injury in belted automobile occupants in frontal collisions.A field survey data analysis was performed to examine the relationship between various occupant and collision factors and the risk of moderate or greater severity injury (i.e., Abbreviated Injury Scale, AIS 2+) to the small intestine, large intestine, or mesentery among belted occupants involved in frontal collisions. Descriptive and comparative risk factor analyses were performed with data originating from that National Automotive Sampling System Crashworthiness Data System (NASS-CDS) over the years 2000–2011. Multivariable logistic regression models were developed to describe the effects of these factors on hollow-organ injury risk. Potential injury mechanisms were further investigated through in-depth examination of select cases exhibiting hollow-organ injuries from the Crash Investigation Research and Engineering Network (CIREN).The inclusion criteria yielded 25,407 individual cases from NASS-CDS, representing a weighted population of 11,373,358 exposed automobile occupants. Within this dataset, 143 cases (weighted frequency: 7962 occupants) exhibited AIS 2+ injury to hollow abdominal organs. Multivariable regression analysis indicated a statistically significant increased risk of moderate or greater severity injuries to the hollow organs of the abdomen with increased in ΔV (odds ratio (OR) 1.07, 95% confidence interval: 1.06–1.09) and age (OR: 1.03, 1.01–1.06). Albeit non-statistically significant, a positive association between BMI and injury risk was observed, especially among obese individuals (OR: 3.55, 0.82–15.2). No association was observed for gender or seated location within the vehicle. Resultfrom this study indicate that hollow abdominal organ injury is a universal problem in frontal collisions, not confined to a specific gender or seating location. Examination of CIREN cases suggests these types of injuries are associated with direct loading of the lower abdomen by the lap belt, either through poor initial belt positioning or through a “submarining” type of kinematic where the lap belt slips off of the pelvis and loads into the abdomen. Potential countermeasures against hollow-organ abdominal injury should include measures to improve initial lap belt fit, and to retain engagement of the lap belt on the pelvis throughout the collision event.

ACR Appropriateness Criteria® rib fractures.

Rib fracture is the most common thoracic injury, present in 10% of all traumatic injuries and almost 40% of patients who sustain severe nonpenetrating trauma. Although rib fractures can produce significant morbidity, the diagnosis of associated complications (such as pneumothorax, hemothorax, pulmonary contusion, atelectasis, flail chest, cardiovascular injury, and injuries to solid and hollow abdominal organs) may have a more significant clinical impact. When isolated, rib fractures have a relatively low morbidity and mortality, and failure to detect isolated rib fractures does not necessarily alter patient management or outcome in uncomplicated cases. A standard posteroanterior chest radiograph should be the initial, and often the only, imaging test required in patients with suspected rib fracture after minor trauma. Detailed radiographs of the ribs rarely add additional information that would change treatment, and, although other imaging tests (eg, computed tomography, bone scan) have increased sensitivity for detection of rib fractures, there are little data to support their use. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review process include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

Liver hydatid cyst perforated into the large bowel: a case report

Perforation of the liver hydatid cyst into hollow abdominal organs is an extremely rare complication. A case of two synchronous hydatid cysts in an old lady is presented. The patient had one multilobular cyst perforated into the right colon and another one uncomplicated located at the right ovary. She underwent partial cystectomy, omentoplasty, right hemicolectomy, and total hysterectomy, and had an uneventful recovery.

Pathology scoring system for blast injuries.

A pathology scoring system, initially developed by the Walter Reed Army Institute of Research in collaboration with the Lovelace Biomedical and Environmental Research Institute and currently used in the Jaycor Pathos data base program, was modified to arrive at a severity of injury index for individual animals. With this approach, an animal was assessed for injuries by using an alphanumeric code. External lesions, fractures, and trauma to pharynx/larynx, trachea, lungs, heart, hollow abdominal organs, and solid abdominal organs were assigned individual numerical scores based on the severity of the lesion. The various lesions also were graded as trace, slight, moderate, or extensive, depending upon their severity. Each individual score was divided by its preassigned maximum possible score to arrive at a severity of injury ratio for that organ or system. The presence or absence, and the extent of a pneumothorax, hemothorax, hemoperitoneum, coronary air, or cerebral air were summed and added to the sum of the ratios. The resulting value was then multiplied by 1 or 2, depending upon whether the subject was a survivor or a fatality, to arrive at an adjusted severity of injury index by excluding ear damage values from the sum of the ratios. The severity of injury index was used in conjunction with a single degree of freedom blast model to develop damage risk criteria for blast injury.