Arch Otolaryngol Head Neck Surg 2009, 135:1196–1198.PubMedCrossRef 60. Terris DJ, Anderson SK, Watts TL, Chin E: Laryngeal nerve monitoring and minimally invasive thyroid surgery: complementary technologies. Arch Otolaryngol Head Neck

Surg 2007, 133:1254–1257.PubMedCrossRef”
“Introduction A contrast blush on computed tomography (CT) scan has been identified as a risk factor for failure of nonoperative management (NOM) of splenic injuries [1–3], prompting many centers to perform routine splenic artery angioembolization in the presence of a blush [4, 5]. Using evidence of contrast extravasation on CT scan as an indication for angioembolization, however, has never been subjected to rigorous analysis. In our experience, patients with splenic injuries transferred from other institutions Dactolisib molecular weight specifically for angioembolization have often resolved the blush upon repeat imaging at our hospital. This made us question whether all postinjury

splenic blushes were equivalent. Is evidence of contrast blush a mandate for intervention, or are there some injuries that cease active bleeding due to “”internal tamponade”" within the substance of the spleen? And how does one differentiate such patients? We hypothesized that not all splenic blushes require intervention and that patients may be selectively observed based upon physiologic status. Materials and methods During Cell Cycle inhibitor a 10 year selleck inhibitor period, all patients transferred from an outside hospital with blunt splenic injuries and evidence of active contrast extravasation on initial postinjury CT scan were evaluated. Patients undergoing intervention (angioembolization or splenectomy) were compared to those managed without intervention. Demographic data, laboratory values, vitals, intervention, and outcome were analyzed. Patients with identified pseudoaneurysms were excluded. Statistical analysis was performed using SAS for Windows (SAS Institute, Cory, NC); p-value < 0.05 was considered statistically significant. The Colorado Multi-Institutional Review Board approved this study. stiripentol Results During the

study period, 241 patients with splenic injuries were transferred from an outside hospital, of which 16 had a contrast blush on CT imaging. All contrast blushes were intraparenchymal. The majority (88%) of patients were men with a mean age of 35 ± 5 and mean ISS of 26 ± 3. Mean time of transfer to Denver Health following injury and evaluation at an outside hospital was 6.4 ± 1.5 h. One patient received 1 unit of packed red blood cells during transfer. No patient reported use of anticoagulant or antiplatelet medications. Eight (50%) of these sixteen patients were managed without angioembolization or operation. In the group not undergoing intervention, Focused Abdominal Sonography for Trauma (FAST) examination was positive in six and negative in two patients. In patients undergoing intervention, FAST was positive in two patients and was not performed in the remainder.