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Dotiwala A, Kalakoti P, Grier LR, Quispe M, Scott LK, Conrad SA, Samra NS. Penetrating thoracic injury requiring emergency pneumonectomy supported with two ECMO runs: A testament to multidisciplinary critical care medicine. Trauma Case Rep 2023; 44:100779. [PMID: 36785783 PMCID: PMC9920248 DOI: 10.1016/j.tcr.2023.100779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2023] [Indexed: 02/10/2023] Open
Abstract
Post-traumatic pneumonectomies are uncommon and, if necessary, carry significant mortality. The use of extracorporeal membrane oxygenation (ECMO) for lung injury in trauma patient has demonstrated efficacy with minimal bleeding complications. We report a case of a young man with a penetrating thoracic injury that required a pneumonectomy supported with two separate ECMO runs for pulmonary failure postoperatively.
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Affiliation(s)
- Aryeneesh Dotiwala
- Division of Trauma, Acute Care Surgery & Surgical Critical Care, Department of General Surgery, LSU Health - Shreveport, Shreveport, LA, United States
| | - Piyush Kalakoti
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
- Department of Surgery, Yale School of Medicine, New Haven, CT, United States
| | - Laurie R. Grier
- Department of Emergency Medicine, LSU Health - Shreveport, Shreveport, LA, United States
| | - Marco Quispe
- Department of Emergency Medicine, LSU Health - Shreveport, Shreveport, LA, United States
| | - L. Keith Scott
- Division of Trauma, Acute Care Surgery & Surgical Critical Care, Department of General Surgery, LSU Health - Shreveport, Shreveport, LA, United States
- Department of Emergency Medicine, LSU Health - Shreveport, Shreveport, LA, United States
| | - Steven A. Conrad
- Division of Trauma, Acute Care Surgery & Surgical Critical Care, Department of General Surgery, LSU Health - Shreveport, Shreveport, LA, United States
- Department of Emergency Medicine, LSU Health - Shreveport, Shreveport, LA, United States
| | - Navdeep S. Samra
- Division of Trauma, Acute Care Surgery & Surgical Critical Care, Department of General Surgery, LSU Health - Shreveport, Shreveport, LA, United States
- Corresponding author at: Department of Surgery, Division of Trauma and Surgical Critical Care, LSU Health – Shreveport, Shreveport, LA 71103, United States.
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Savoy J, Ballard DH, Carroll C, Dubose AC, Caldito G, Samra NS. “Academic Epinephrine”—Smartphone Use as an Educational Tool for Trainees: Survey Results after Implementation of Texting-Based Educational Material in a General Surgery Residency Program. Am Surg 2020. [DOI: 10.1177/000313481908501115] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- John Savoy
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - David H. Ballard
- Mallinckrodt Institute of Radiology Washington University School of Medicine St. Louis, Missouri
| | - Caroline Carroll
- Department of Anesthesiology Louisiana State University Health Shreveport Shreveport, Louisiana
| | - Arielle C. Dubose
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - Gloria Caldito
- Department of Neurology Louisiana State University Health Shreveport Shreveport, Louisiana
| | - Navdeep S. Samra
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
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Savoy J, Ballard DH, Carroll C, Dubose AC, Caldito G, Samra NS. "Academic Epinephrine"-Smartphone Use as an Educational Tool for Trainees: Survey Results after Implementation of Texting-Based Educational Material in a General Surgery Residency Program. Am Surg 2019; 85:e553-e555. [PMID: 31775990 PMCID: PMC7005929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- John Savoy
- Department of Surgery, Louisiana State University Health Shreveport, LA
| | - David H. Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Caroline Carroll
- Department of Anesthesiology, Louisiana State University Health Shreveport, LA
| | - Arielle C. Dubose
- Department of Surgery, Louisiana State University Health Shreveport, LA
| | - Gloria Caldito
- Department of Neurology, Louisiana State University Health Shreveport, LA
| | - Navdeep S. Samra
- Department of Surgery, Louisiana State University Health Shreveport, LA
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Delafontaine JL, Moreci R, Samra NS. Acute splenic rupture following laparoscopic pneumoperitoneum: A case report. Trauma Case Rep 2019; 22:100211. [PMID: 31338406 PMCID: PMC6620620 DOI: 10.1016/j.tcr.2019.100211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2019] [Indexed: 12/03/2022] Open
Abstract
Introduction Splenic rupture after laparoscopic surgery is a very rare complication. In this study, we report a case of a splenic laceration that occurred during a laparoscopic gastrostomy tube placement. The theorized mechanism in this case was acute disruption of a peri-splenic hematoma. Case report A 64-year-old African-American male presented after a motor vehicle accident with multiple injuries and was admitted to a surgical intensive care unit, where he declined from ICU days 6 through 11. The patient underwent tracheostomy and laparoscopic gastrostomy tube placement given his significant neurologic deficits. Intraoperatively, the patient developed hypotension, leading to the discovery of hemoperitoneum and necessitating an emergent open splenectomy. Conclusion Splenic rupture following laparoscopic procedures is a very rare phenomenon. In this case, we believe the splenic rupture was secondary to an acute disruption of a previously hemostatic splenic hematoma involving the abdominal wall during creation of capnoperitoneum.
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Affiliation(s)
- Jean-Luc Delafontaine
- Department of Surgery, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, USA
| | - Rebecca Moreci
- Louisiana State University School of Medicine, Shreveport, LA, USA
| | - Navdeep S Samra
- Department of Trauma, Acute Care Surgery, and Surgical Critical Care, Louisiana State University Health Sciences Center, Shreveport, LA, USA
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Abstract
In March 2016, we reported the SSI rate at LSU Health for all abdominal wall hernia repairs performed between 2011 and 2013. Among the 263 repairs, the infection rate averaged 6.8 per cent. Given the diversity of repairs, this global percentage lacks relevance, but looking at subsets provides meaningful insights. For example, SSI was 1.8 per cent among 55/263 laparoscopic repairs and 8.2 per cent among 206/263 open repairs. The infection rate of 26.3 per cent among the 19 open component separation cases was especially noteworthy and bothersome. Even though there was no mortality in any subset, the vast majority of the morbidity and costs involved repairs with open component separations. A meta-analysis published in 2016 revealed a likely SSI benefit for the endoscopic component separation technique (ECST) over the open CST. Since that report, we have focused our quality improvement efforts on this subset of challenging cases and have replaced CST with ECST. Our data now include results from 33 hernia repairs with either CSTor ECST that were performed between November 2011 and April 2018. Twenty-four of 33 patients had CSTwith an SSI rate of 37.5 per cent (9 of 24). Nine of 33 had ECST with 0 per cent SSI (P value = 0.039). These results mirror the findings reported in the meta-analysis.
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Affiliation(s)
- Derek S. Palmer
- Department of Surgery, LSU Health Shreveport, Shreveport, Louisiana
| | | | - Navdeep S. Samra
- Department of Surgery, LSU Health Shreveport, Shreveport, Louisiana
| | - F. Dean Griffen
- Department of Surgery, LSU Health Shreveport, Shreveport, Louisiana
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Palmer DS, McDaniel CC, Samra NS, Griffen FD. Comparing Surgical Site Infection for Open and Endoscopic Component Separation. Am Surg 2019; 85:350-352. [PMID: 31043193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In March 2016, we reported the SSI rate at LSU Health for all abdominal wall hernia repairs performed between 2011 and 2013. Among the 263 repairs, the infection rate averaged 6.8 per cent. Given the diversity of repairs, this global percentage lacks relevance, but looking at subsets provides meaningful insights. For example, SSI was 1.8 per cent among 55/263 laparoscopic repairs and 8.2 per cent among 206/263 open repairs. The infection rate of 26.3 per cent among the 19 open component separation cases was especially noteworthy and bothersome. Even though there was no mortality in any subset, the vast majority of the morbidity and costs involved repairs with open component separations. A meta-analysis published in 2016 revealed a likely SSI benefit for the endoscopic component separation technique (ECST) over the open CST. Since that report, we have focused our quality improvement efforts on this subset of challenging cases and have replaced CST with ECST. Our data now include results from 33 hernia repairs with either CST or ECST that were performed between November 2011 and April 2018. Twenty-four of 33 patients had CST with an SSI rate of 37.5 per cent (9 of 24). Nine of 33 had ECST with 0 per cent SSI (P value = 0.039). These results mirror the findings reported in the meta-analysis.
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Awe A, Ballard DH, Burger M, Abrams AC, Caldito G, Chu Q, Samra NS. Innovative Teaching Strategies for Surgery Resident Education Sessions: Learner Preference of Slide-based Presentations versus Focused Study Guides. Am Surg 2018; 84:e541-e543. [PMID: 30606370 PMCID: PMC6511882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Adebayo Awe
- Department of Surgery, Louisiana State University Health Shreveport, LA
| | - David H. Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Matthew Burger
- Department of Surgery, Louisiana State University Health Shreveport, LA
| | - Ashley C. Abrams
- Department of Surgery, Louisiana State University Health Shreveport, LA
| | - Gloria Caldito
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
| | - Quyen Chu
- Department of Surgery, Louisiana State University Health Shreveport, LA
| | - Navdeep S. Samra
- Department of Surgery, Louisiana State University Health Shreveport, LA
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Smith JP, Samra NS, Ballard DH, Moss JB, Griffen FD. Prophylactic Antibiotics for Elective Laparoscopic Cholecystectomy. Am Surg 2018; 84:576-580. [PMID: 29712609 PMCID: PMC6468984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Surgical site infections with elective laparoscopic cholecystectomy are less frequent and less severe, leading some to suggest that prophylactic antibiotics (PA) are no longer indicated. We compared the incidence of surgical site infections before and after an institutional practice change of withholding PA for elective laparoscopic cholecystectomy. Between May 7, 2013, and March 11, 2015, no PA were given to patients selected for elective cholecystectomy by two surgeons at a single center. The only patients excluded were those who received antibiotics before surgery for any reason. All others, including those at high risk for infection, were included. The incidence and severity of infections were compared with historical controls treated with prophylaxis by the same two surgeons from November 6, 2011, to January 13, 2013. There were 268 patients in the study group and 119 patients in the control group. Infection occurred in 3.0 per cent in the study group compared with 0.9 per cent in the controls (P = 0.29). All infections were mild except one. Based on these data, the routine use of PA for elective laparoscopic cholecystectomy is not supported.
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Abstract
Surgical site infections with elective laparoscopic cholecystectomy are less frequent and less severe, leading some to suggest that prophylactic antibiotics (PA) are no longer indicated. We compared the incidence of surgical site infections before and after an institutional practice change of withholding PA for elective laparoscopic cholecystectomy. Between May 7, 2013, and March 11, 2015, no PA were given to patients selected for elective cholecystectomy by two surgeons at a single center. The only patients excluded were those who received antibiotics before surgery for any reason. All others, including those at high risk for infection, were included. The incidence and severity of infections were compared with historical controls treated with prophylaxis by the same two surgeons from November 6, 2011, to January 13, 2013. There were 268 patients in the study group and 119 patients in the control group. Infection occurred in 3.0 per cent in the study group compared with 0.9 per cent in the controls ( P = 0.29). All infections were mild except one. Based on these data, the routine use of PA for elective laparoscopic cholecystectomy is not supported.
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Affiliation(s)
- J. Patrick Smith
- Department of Surgery, Louisiana State University Health Shreveport, Shreveport, Louisiana
| | - Navdeep S. Samra
- Department of Surgery, Louisiana State University Health Shreveport, Shreveport, Louisiana
| | - David H. Ballard
- Department of Surgery, Louisiana State University Health Shreveport, Shreveport, Louisiana
| | - Jonathan B. Moss
- Department of Surgery, Louisiana State University Health Shreveport, Shreveport, Louisiana
| | - Forrest D. Griffen
- Department of Surgery, Louisiana State University Health Shreveport, Shreveport, Louisiana
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Darvie PJ, Ballard DH, Harris N, Bhargava P, Rao VR, Samra NS. Occult lawn mower projectile injury presenting with hemoptysis. Radiol Case Rep 2018; 12:678-681. [PMID: 29484047 PMCID: PMC5823315 DOI: 10.1016/j.radcr.2017.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 07/27/2017] [Accepted: 08/08/2017] [Indexed: 10/28/2022] Open
Abstract
We present the case of a 72-year-old man with hemoptysis after a thoracic projectile injury, which occurred while mowing the lawn. Chest radiograph followed by a computed tomography angiogram revealed a metallic foreign body in the right middle lobe of the lung. The patient underwent a right anterolateral thoracotomy where the object was successfully retrieved. The patient had an uneventful postoperative recovery.
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Affiliation(s)
- Patric J Darvie
- School of Medicine, Louisiana State University Health-Shreveport, Louisiana, USA
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, St. Louis, MO 63110, USA
| | - Nicholas Harris
- Department of Surgery, Louisiana State University Health-Shreveport, Louisiana, USA
| | - Peeyush Bhargava
- Department of Radiology, Louisiana State University Health-Shreveport, Louisiana
| | - Vyas R Rao
- Department of Surgery, Louisiana State University Health-Shreveport, Louisiana, USA
| | - Navdeep S Samra
- Department of Surgery, Louisiana State University Health-Shreveport, Louisiana, USA
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Carter T, Ballard DH, Bhargava P, Samra NS. Obturator Hernia, 'The Little Old Lady Hernia'. J La State Med Soc 2017; 169:96-98. [PMID: 28850555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Obturator hernia is a rare type of abdominal hernia that classically presents in elderly women. We report the case of 78-year-old woman with progressive vomiting, obstipation, and abdominal pain. Contrast-enhanced computed tomography showed a left-sided obturator hernia, which was confirmed and treated at laparotomy. Demographics, symptoms, imaging findings, and management of obturator hernias is reviewed.
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Affiliation(s)
- Taylor Carter
- Louisiana State University Health, School of Medicine - Shreveport, LA
| | - David H Ballard
- Mallinckrodt Institute of Radiology, Washington University School of Medicine - St Louis, Missouri
| | - Peeyush Bhargava
- Louisiana State University Health, Department of Radiology - Shreveport, LA
| | - Navdeep S Samra
- Louisiana State University Health, Department of Surgery - Shreveport, LA
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Sun H, Samra NS, Kalakoti P, Sharma K, Patra DP, Dossani RH, Thakur JD, Disbrow EA, Phan K, Veeranki SP, Pabaney A, Notarianni C, Owings JT, Nanda A. Impact of Prehospital Transportation on Survival in Skiers and Snowboarders with Traumatic Brain Injury. World Neurosurg 2017; 104:909-918.e8. [PMID: 28559075 DOI: 10.1016/j.wneu.2017.05.108] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 05/17/2017] [Accepted: 05/18/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Prehospital helicopter use and its impact on outcomes in snowboarders and skiers incurring traumatic brain injury (TBI) is unknown. The present study investigates the association of helicopter transport with survival of snowboarders and skiers with TBI, in comparison with ground emergency medical services (EMS), by using data derived from the National Trauma Data Bank (2007-2014). METHODS Primary and secondary endpoints were defined as in-hospital survival and absolute risk reduction based upon number needed to transport (treat) respectively. Multivariable regression models including traditional logit model, model fitted with generalized estimating equations, and those incorporating results from propensity score matching methods were used to investigate the association of helicopter transport with survival compared with ground EMS. RESULTS Of the 1018 snowboarders and skiers who met the criteria, 360 (35.4%) were transported via helicopters whereas 658 (64.6%) via ground EMS with a mortality rate of 1.7% and 1.5%, respectively. Multivariable log-binomial models demonstrated association of prehospital helicopter transport with increased survival (odds ratio 8.58; 95% confidence interval 1.09-67.64; P = 0.041; absolute risk reduction: 10.06%). This finding persisted after propensity score matching (odds ratio 24.73; 95% confidence interval 5.74-152.55; P < 0.001). The corresponding absolute risk reduction implies that approximately 10 patients need to be transported via helicopter to save 1 life. CONCLUSIONS Based on our robust statistical analysis of retrospective data, our findings suggest prehospital helicopter transport improved survival in patients incurring TBI after snowboard- or ski-related falls compared with those transported via ground EMS. Policies directed at using helicopter services at remote winter resorts or ski or snowboarding locations should be implemented.
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Affiliation(s)
- Hai Sun
- Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
| | - Navdeep S Samra
- Department of Trauma and Surgical Critical Care, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Piyush Kalakoti
- Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Kanika Sharma
- Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Devi Prasad Patra
- Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Rimal H Dossani
- Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Jai Deep Thakur
- Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Elizabeth A Disbrow
- Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Kevin Phan
- NeuroSpine Surgery Research Group (NSURG), Barker St. Randwick, Prince of Wales Private Hospital, Sydney, Australia
| | - Sreenivas P Veeranki
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Galveston, Texas, USA
| | - Aqueel Pabaney
- Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Christina Notarianni
- Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - John T Owings
- Department of Trauma and Surgical Critical Care, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
| | - Anil Nanda
- Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA
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Affiliation(s)
- David H. Ballard
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - G. Patton Pennington
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - Quyen D. Chu
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - Navdeep S. Samra
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
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Ballard DH, Pelliccio N, Rudd J, Caldito G, Chu QD, Samra NS. Pediatric Pedestrians and Bicyclists versus Motor Vehicle Accidents: Comparison of Injury Patterns by Mechanism and Influence of Socioeconomic Status. Am Surg 2017. [DOI: 10.1177/000313481708300508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- David H. Ballard
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - Nicholas Pelliccio
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - Justin Rudd
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - Gloria Caldito
- Department of Neurology Louisiana State University Health Shreveport Shreveport, Louisiana
| | - Quyen D. Chu
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - Navdeep S. Samra
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
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Ballard DH, Pelliccio N, Rudd J, Caldito G, Chu QD, Samra NS. Pediatric Pedestrians and Bicyclists versus Motor Vehicle Accidents: Comparison of Injury Patterns by Mechanism and Influence of Socioeconomic Status. Am Surg 2017; 83:e165-e167. [PMID: 28541844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Ballard DH, Pennington GP, Chu QD, Samra NS. Resident Duty Hours and American Board of Surgery In-Training Examination Performance. Am Surg 2017; 83:e151-e152. [PMID: 28541838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Ballard DH, Samra NS, Griffen FD. Evolving insights for preventing surgeon errors: Balancing professionalism and cognition with knowledge and skill. Bull Am Coll Surg 2017; 102:10-18. [PMID: 28920656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Affiliation(s)
- David H Ballard
- Department of Surgery, Louisiana State University Health Shreveport, Shreveport, LA, USA.
| | - Mallory Williams
- Department of Surgery, Howard University Hospital, Washington, DC, USA
| | - Navdeep S Samra
- Department of Surgery, Louisiana State University Health Shreveport, Shreveport, LA, USA
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Ballard DH, Fransman RB, Sangster GP, Ayo M, Samra NS. Jejunal Carcinoid Tumors Presenting as Small Bowel Obstruction. J La State Med Soc 2017; 169:15-17. [PMID: 28218630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Carcinoid tumors are the most common form of gut neuroendocrine tumors, however, they rarely present with small bowel obstruction. We present a case of a 65-year-old woman without prior abdominal operations who presented with symptoms of small bowel obstruction. Computed tomography (CT) showed multiple air fluid levels and a transition point in the left mesentery with two soft tissue densities at the same level. The patient was taken to the operating room for surgical exploration, which showed two intramural masses in the mid and distal jejunum, which surgical pathology showed to be stage IIIB carcinoid tumor.
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Affiliation(s)
| | | | | | | | - Navdeep S Samra
- Assistant Professor - Trauma, Acute Care Surgery and Surgical Critical Care at LSU Health - Shreveport
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Ballard DH, Samra NS, Griffen FD. Patient handoffs in surgery: Successes, failures and room for improvement. World J Surg Proced 2016; 6:8-12. [DOI: 10.5412/wjsp.v6.i1.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 01/27/2016] [Accepted: 03/16/2016] [Indexed: 02/06/2023] Open
Abstract
Patient handoffs are transitions where communication failures may lead to errors in patient care. Face-to-face handoffs are preferred, however may not always be feasible. Different models and strategies have been described, yet there are few experimental studies. Expanding the problem, the on-call surgeon may be responsible for many patients, few or none that they admitted. Effective handoffs improve the quality of care and result in fewer errors. Herein we review different models of patient handoffs, comment on common pitfalls, and suggest areas for new research.
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Thompson NB, Ballard DH, Pahilan ME, Conrad TS, Samra NS, Youssef AM. Pediatric All-terrain Vehicle Crashes at a Trauma Center in Northwestern Louisiana: 10-year Analysis. Am Surg 2016; 82:E69-E70. [PMID: 27099050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Norris B Thompson
- Department of Surgery, Louisiana State University Health Shreveport, Shreveport, Louisiana, USA
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Ballard DH, Samra NS, Pennywell DJ, Griffen FD. Is the Surgical Site Infection Rate after Ventral/Incisional Hernia Repair Higher in a Facility Not Participating in a National Surgical Quality Improvement Program? Am Surg 2016; 82:289-290. [PMID: 27099068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- David H Ballard
- Department of Surgery, Louisiana State University Health Shreveport, Shreveport, Louisiana, USA
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Thompson NB, Ballard DH, Pahilan ME, Conrad TS, Samra NS, Youssef AM. Pediatric All-terrain Vehicle Crashes at a Trauma Center in Northwestern Louisiana: 10-year Analysis. Am Surg 2016. [DOI: 10.1177/000313481608200307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Norris B. Thompson
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - David H. Ballard
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - M. Elaine Pahilan
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - Taylor S. Conrad
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - Navdeep S. Samra
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - Asser M. Youssef
- Chandler Regional Medical Center Chandler, Arizona and the University of Arizona College of Medicine-Phoenix Phoenix, Arizona
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Ballard DH, Samra NS, Pennywell DJ, Griffen FD. Is the Surgical Site Infection Rate after Ventral/ Incisional Hernia Repair Higher in a Facility Not Participating in a National Surgical Quality Improvement Program? Am Surg 2016. [DOI: 10.1177/000313481608200325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- David H. Ballard
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - Navdeep S. Samra
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - David J. Pennywell
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - F. Dean Griffen
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
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25
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Affiliation(s)
- David H Ballard
- Department of Surgery, Louisiana State University Health Shreveport, Shreveport, LA
| | - Navdeep S Samra
- Department of Surgery, Louisiana State University Health Shreveport, Shreveport, LA.
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Cerise AC, Jahromi AH, Ballard DH, Chu QD, Youssef AM, Pahilan ME, Warren PH, Samra NS. Does the Insurance Status Predict the Outcome of the Trauma Patients with Abdominal Gunshot Wounds? Report from a Level I Trauma Academic Center with a Public Hospital. Am Surg 2016. [DOI: 10.1177/000313481608200115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Adam C. Cerise
- Department of Surgery Indiana University School of Medicine Indianapolis, Indiana
| | | | - David H. Ballard
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - Quyen D. Chu
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - Asser M. Youssef
- Department of Surgery, Chandler Regional Medical Center Chandler, Arizona; and University of Arizona College of Medicine Phoenix, Arizona
| | - M. Elaine Pahilan
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - Patsy H. Warren
- Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
| | - Navdeep S. Samra
- Division of Trauma and Critical Care Surgery Department of Surgery Louisiana State University Health Shreveport Shreveport, Louisiana
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27
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Cerise AC, Hamidian Jahromi A, Ballard DH, Chu QD, Youssef AM, Pahilan ME, Warren PH, Samra NS. Does the Insurance Status Predict the Outcome of the Trauma Patients with Abdominal Gunshot Wounds? Report from a Level I Trauma Academic Center with a Public Hospital. Am Surg 2016; 82:E25-E27. [PMID: 26802849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Adam C Cerise
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Abstract
Sliding inguinal hernias are often unexpected intraoperative findings, and repair of which can be technically challenging. A number of repair techniques have been described. The author modified a technique based on an approach described by Bevan. The purpose of our study is to describe this modified Bevan technique for repair of sliding inguinal hernias and report its efficacy in a series of patients. We retrospectively reviewed all patients with open inguinal hernia repairs performed by a single surgeon from August 2007 to April 2013 for sliding indirect hernias using the modified Bevan technique. Patient records were reviewed for demographics, hernia characteristics, complications, admission status, length of stay, and complications. There were 25 patients eligible for our review (male = 25, mean age = 49 years). All sliding hernias were indirect, none were bilateral, and two were incarcerated. The sliding component involved the bladder and perivesical fat (n = 12), sigmoid colon (n = 10), and the cecum and appendix (n = 3). Eighteen patients were treated as outpatients; seven patients were admitted with a mean stay of 2.2 days. Complications included intra-operative bleeding (n = 1), subcutaneous wound hematoma (n = 1), scrotal seroma (n = 1), transient orchialgia (n = 1), and ileus (n = 1). All patients were seen postoperatively for short-term follow-up with no hernia recurrences. Thirteen patients were available for long-term follow-up (mean = 13.6 months); all had no hernia recurrences. The modification of Bevan's technique for repair of large sliding hernias worked well in our series.
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Affiliation(s)
- Navdeep S. Samra
- Department of Surgery Louisiana State University Health Shreveport, Shreveport, Louisiana
| | | | - Darin F. Doumite
- Department of Surgery Louisiana State University Health Shreveport, Shreveport, Louisiana
| | - F. Dean Griffen
- Department of Surgery Louisiana State University Health Shreveport, Shreveport, Louisiana
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29
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Samra NS, Ballard DH, Doumite DF, Griffen FD. Repair of Large Sliding Inguinal Hernias. Am Surg 2015; 81:1204-1208. [PMID: 26736154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Sliding inguinal hernias are often unexpected intra-operative findings, and repair of which can be technically challenging. A number of repair techniques have been described. The author modified a technique based on an approach described by Bevan. The purpose of our study is to describe this modified Bevan technique for repair of sliding inguinal hernias and report its efficacy in a series of patients. We retrospectively reviewed all patients with open inguinal hernia repairs performed by a single surgeon from August 2007 to April 2013 for sliding indirect hernias using the modified Bevan technique. Patient records were reviewed for demographics, hernia characteristics, complications, admission status, length of stay, and complications. There were 25 patients eligible for our review (male = 25, mean age = 49 years). All sliding hernias were indirect, none were bilateral, and two were incarcerated. The sliding component involved the bladder and perivesical fat (n = 12), sigmoid colon (n = 10), and the cecum and appendix (n = 3). Eighteen patients were treated as outpatients; seven patients were admitted with a mean stay of 2.2 days. Complications included intra-operative bleeding (n = 1), subcutaneous wound hematoma (n = 1), scrotal seroma (n = 1), transient orchialgia (n = 1), and ileus (n = 1). All patients were seen postoperatively for short-term follow-up with no hernia recurrences. Thirteen patients were available for long-term follow-up (mean = 13.6 months); all had no hernia recurrences. The modification of Bevan's technique for repair of large sliding hernias worked well in our series.
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Affiliation(s)
- Navdeep S Samra
- Department of Surgery Louisiana State University Health Shreveport, Shreveport, Louisiana, USA
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Williams M, Ballard DH, DeLeonardis C, Prasad J, Wigle R, Johnson LW, Pahilan ME, Samra NS. Pediatric unintentional firearm injuries: a Northwestern Louisiana trauma center analysis. Am Surg 2015; 81:653-654. [PMID: 26031283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Mallory Williams
- Department of Surgery, University of Toledo College of Medicine, Toledo, Ohio, USA
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Williams M, Prasad J, Ballard DH, DeLeonardis C, Wigle R, Pahilan ME, Samra NS, Johnson LW. Pediatric Unintentional Firearm Injuries: A Northwestern Louisiana Trauma Center Analysis. Am Surg 2015. [DOI: 10.1177/000313481508100634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Mallory Williams
- Department of Surgery, University of Toledo College of Medicine, Toledo, Ohio
| | - Jai Prasad
- Department of Surgery, University of Toledo College of Medicine, Toledo, Ohio
| | - David H. Ballard
- School of Medicine, University of Toledo College of Medicine, Toledo, Ohio
| | - Caroline DeLeonardis
- Department of Surgery, Louisiana State University Health Shreveport, Shreveport, Louisiana
| | - Richard Wigle
- Department of Surgery, Louisiana State University Health Shreveport, Shreveport, Louisiana
| | - M. Elaine Pahilan
- Department of Surgery, Louisiana State University Health Shreveport, Shreveport, Louisiana
| | - Navdeep S. Samra
- Department of Surgery, Louisiana State University Health Shreveport, Shreveport, Louisiana
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Samra NS, Ravi AK, Johnson LW, Williams M. Traumatic bilateral carotid artery dissection. J La State Med Soc 2011; 163:26-28. [PMID: 21675003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Bilateral carotid artery dissection following blunt trauma is a rare but potentially lethal injury if not diagnosed early and treated. CASE REPORT We report a collision patient who suffered bilateral asymptomatic carotid artery dissections. He also had multiple fractures of the pelvis and upper and lower extremities. The patient was managed acutely with aspirin. He underwent open reduction and internal fixation of fractures without complication and was discharged home on aspirin. DISCUSSION Carotid artery dissections are increasingly being recognized in blunt trauma patients. Management options include systemic anticoagulation versus antiplatelet therapy. The need to acutely address the carotid artery injury must be balanced with the need for hemostasis with associated solid organ injury and/or future operative procedures. CONCLUSIONS Carotid artery dissections should be screened for in patients with appropriate mechanism of injury. This case report details the successful management of a patient of bilateral carotid artery dissection and other major orthopedic injuries using aspirin.
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Affiliation(s)
- Navdeep S Samra
- Louisiana State University Health Sciences Center-Shreveport, USA
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Abstract
A 56-year-old man complained of dyspnea and cough 9 days after coronary artery bypass grafting. Chest radiography showed opacity and left lung collapse. Following removal of clots from the pleural cavity by videothoracoscopy, he recovered without further incident. Video-assisted thoracic surgery is a feasible and safe option in the management of early hemothorax.
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Affiliation(s)
- Shivpreet S Samra
- Department of Cardiovascular and Thoracic Surgery, Fortis Heart Institute, Mohali, India.
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