1
|
Ishiki Y, Takiguchi T, Kim S, Arai M, Ishii H, Hagiwara J, Hagiwara O, Ogasawara T, Teraoka S, Ogawa F, Yokobori S. Delayed stomach necrosis in a patient with injured celiac artery branches after penetrating abdominal trauma. Trauma Case Rep 2023; 47:100904. [PMID: 37608874 PMCID: PMC10440351 DOI: 10.1016/j.tcr.2023.100904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2023] [Indexed: 08/24/2023] Open
Abstract
Injuries of the celiac artery and its branches are rare, but potentially lethal. Ligation of these arteries is performed to control significant hemorrhage. However, few reports have described the adverse effects of ligating these arteries. A 69-year-old woman with a self-inflicted stab wound was brought to our hospital. Her blood pressure could not be measured, therefore aortic cross-clamping was performed, and epinephrine was administered for resuscitation, an emergency laparotomy was performed, and the roots of splenic artery and common hepatic artery were ligated. The left gastric artery which was anomalous and arose directly from the aorta, was also injured and had to be ligated. Norepinephrine was required after the surgery. Enhanced computed tomography performed on hospital day 4 revealed a disrupted celiac artery. The patient developed gastric necrosis on hospital day 23 and, hence, underwent total gastrectomy was performed. The possibility of delayed stomach necrosis should be considered during the postoperative management of patients who undergo ligation of all of the celiac artery branches and experience global hypoperfusion after the surgery.
Collapse
Affiliation(s)
- Yoshito Ishiki
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
- Department of Emergency and Critical Care Medicine, Kawaguchi Municipal Hospital, Saitama, Japan
| | - Toru Takiguchi
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
- Department of Emergency and Critical Care Medicine, Kawaguchi Municipal Hospital, Saitama, Japan
| | - Shiei Kim
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| | - Masatoku Arai
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| | - Hiromoto Ishii
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| | - Jun Hagiwara
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| | - Osahiko Hagiwara
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
- Department of Surgery, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Tomoko Ogasawara
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| | - Shintaro Teraoka
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| | - Futoshi Ogawa
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
- Department of Emergency and Critical Care Medicine, Kawaguchi Municipal Hospital, Saitama, Japan
| | - Shoji Yokobori
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| |
Collapse
|
2
|
Sosnowska-Sienkiewicz P, Strauss E, Bućko E, Dopierała M, Mańkowski P, Januszkiewicz-Lewandowska D. Are There Any Limiting Factors of Minimally Invasive Adrenalectomy in Children? Over 20-Year Single-Center Experience. POLISH JOURNAL OF SURGERY 2022; 94:46-53. [DOI: 10.5604/01.3001.0015.7783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
<b> Introduction:</b> Laparoscopic adrenalectomy is more widely recognized as a valuable treatment method for benign and malignant tumours. </br></br> <b>Aim:</b> This study reviews over 20-year experience with laparoscopic adrenalectomy in children in Central-West Poland. </br></br> <b>Materials and methods:</b> During the last 21 years, 5041 laparoscopic procedures were performed, among them 39 adrenalectomies in children aged from 2 days to 17 years. The following data were analysed: patient's age at diagnosis and surgery, lesion volume in CT/MRI examination, duration of surgery, the incidence of complication after surgery, and length of hospitalization. </br></br> <b>Results:</b> The volume of adrenal lesion visualized by CT or MRI before surgery varied from 0.5 cm3 up to 490 cm3, with a median of 14 cm3. As many as 80% of adrenalectomies allowed radical removal of the lesion and 92% of those procedures were performed without any complications. From all data analysed, only age, both at diagnosis and at surgery, was significantly lower in patients with a malignant lesion. </br></br> <b>Conclusions:</b> Laparoscopic adrenalectomy is a valuable method to use in paediatric patients for both benign and malignant adrenal lesions. However, in patients with malignant adrenal lesions it may be expected that the procedure will be more difficult due to the lower age and larger lesion size.
Collapse
Affiliation(s)
| | - Ewa Strauss
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Ewa Bućko
- Karol Jonscher Hospital, Poznan, Poland
| | - Maria Dopierała
- Student Scientific Group of Pediatric Surgery, Poznan University of Medical Sciences, Poland
| | | | | |
Collapse
|