Articles

Emergency General Surgery: evolution of a subspecialty by stealth

Emergency surgical patients account for around half of all NHS surgical workload and 80 % of surgical deaths. Few trainees opt to CCT in General Surgery, and there is no recognised subspecialty training progra...

Authors: L. Pearce, S. R. Smith, E. Parkin, C. Hall, J. Kennedy and A. Macdonald

Intraoperative diagnosis of solitary cecal diverticulum not requiring surgery: is appendectomy indicated?

To compare experience with solitary cecal diverticulum (SCD) with literature on the indication for appendectomy in cases of solitary cecal diverticulitis.

Authors: Renol M. Koshy, Abdelrahman Abusabeib, Saif Al-Mudares, Mohamed Khairat, Adriana Toro and Isidoro Di Carlo

Patient-reported health-related quality of life after a displaced intra-articular calcaneal fracture: a systematic review

A displaced intra-articular calcaneal fracture (DIACF) is known for having a negative influence on the daily activities of patients. A health-related quality of life (HRQoL) outcome instrument is used to quant...

Authors: G. Alexandridis, A. C. Gunning and L. P. H. Leenen

Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections: a prospective multicentre study (WISS Study)

To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of...

Authors: Massimo Sartelli, Fikri M. Abu-Zidan, Fausto Catena, Ewen A. Griffiths, Salomone Di Saverio, Raul Coimbra, Carlos A. Ordoñez, Ari Leppaniemi, Gustavo P. Fraga, Federico Coccolini, Ferdinando Agresta, Asrhaf Abbas, Saleh Abdel Kader, John Agboola, Adamu Amhed, Adesina Ajibade…

Acute appendicitis: proposal of a new comprehensive grading system based on clinical, imaging and laparoscopic findings

Advances in the technology and improved access to imaging modalities such as Computed Tomography and laparoscopy have changed the contemporary diagnostic and management of acute appendicitis. Complicated appen...

Authors: Carlos Augusto Gomes, Massimo Sartelli, Salomone Di Saverio, Luca Ansaloni, Fausto Catena, Federico Coccolini, Kenji Inaba, Demetrios Demetriades, Felipe Couto Gomes and Camila Couto Gomes

Critically ill patients with acute cholecystitis are at increased risk for extensive gallbladder inflammation

Acute cholecystitis is a common diagnosis and surgery is the standard of care for young and fit patients. However, due to high risk of postoperative morbidity and mortality, surgical management of critically i...

Authors: Marios Papadakis, Peter C. Ambe and Hubert Zirngibl

Massive hemothorax due to inferior phrenic artery injury after blunt trauma

Injury to the inferior phrenic artery after blunt trauma is an extremely rare event, and it may occur under unanticipated conditions. This case report describes an injury to the left inferior phrenic artery ca...

Authors: Makoto Aoki, Kei Shibuya, Minoru Kaneko, Ayana Koizumi, Masato Murata, Jun Nakajima, Shuichi Hagiwara, Masahiko Kanbe, Yoshinori Koyama, Yoshito Tsushima and Kiyohiro Oshima

Intra-abdominal hypertension; prevalence, incidence and outcomes in a low resource setting; a prospective observational study

Intra-abdominal hypertension (IAH) is defined as a sustained elevation in intra-abdominal pressure (IAP) greater than or equal to 12 mmHg. IAH has been shown to cause organ derangements and dysfunction in the ...

Authors: Job Kuteesa, Olivia Kituuka, Dan Namuguzi, Cynthia Ndikuno, Samuel Kirunda, David Mukunya and Moses Galukande

Erratum to: caustic ingestion management: world society of emergency surgery preliminary survey of expert opinion

Authors: Yoram Kluger, Ofir Ben Ishay, Massimo Sartelli, Amit Katz, Luca Ansaloni, Carlos Augusto Gomez, Walter Biffl, Fausto Catena, Gustavo P. Fraga, Salomone Di Saverio, Augustin Goran, Wagih Ghnnam, Jeffry Kashuk, Ari Leppäniemi, Sanjay Marwah, Ernest E. Moore…

Occult fractures of the proximal femur: imaging diagnosis and management of 82 cases in a regional trauma center

Occult hip fractures are often difficult to identify in busy trauma units. We aimed to present our institutions experience in the diagnosis and treatment of occult fractures around the hip and to help define a...

Authors: Bogdan Deleanu, Radu Prejbeanu, Eleftherios Tsiridis, Dinu Vermesan, Dan Crisan, Horia Haragus, Vlad Predescu and Florin Birsasteanu

The impact of early surgical intervention in free intestinal perforation: a time-to-intervention pilot study

An abdominal inflammatory focus is the second most often source of sepsis with a high risk of death in surgical intensive care units. By establishing evidence-based bundled strategies the surviving sepsis camp...

Authors: Andreas Hecker, E. Schneck, R. Röhrig, F. Roller, B. Hecker, J. Holler, C. Koch, M. Hecker, M. Reichert, C. Lichtenstern, G. A. Krombach, W. Padberg and M. A. Weigand

Metallothionein ameliorates burn sepsis partly via activation of Akt signaling pathway in mice: a randomized animal study

Metallothioneins (MTs) are a family of cysteine-rich and low molecular-weight proteins that can regulate metal metabolism and act as antioxidants. Recent studies showed that MTs played a protective role in exc...

Authors: Keqin Luo, Huibao Long, Bincan Xu and Yanling Luo

Gunshot wound without entrance hole: where is the trick? A case report and review of the literature

The presence at CT scan of more retained bullets than expected could be a very difficult interpretation challenge in the early management of gunshot wounds. The modern non operative management of haemodinamica...

Authors: Silvia Ministrini, Gianluca Baiocchi, Frida Pittiani, Daniele Lomiento, Federico Gheza and Nazario Portolani

Antibiotics alone versus appendectomy to treat uncomplicated acute appendicitis in adults: what do meta-analyses say?

Primary appendectomy is the current standard of care for treating uncomplicated acute appendicitis, but interest in conservative treatment with antibiotics alone has been increasing in recent years. Clinical t...

Authors: Leonardo Lima Rocha, Felipe Martin Bianco Rossi, Camila Menezes Souza Pessoa, Flavia Nunes Dias Campos, Carlos Eduardo Fonseca Pires and Milton Steinman

Transcatheter thrombolysis combined with damage control surgery for treatment of acute mesenteric venous thrombosis associated with bowel necrosis: a retrospective study

This study aims to evaluate the clinical outcomes of transcatheter thrombolysis in acute superior mesenteric venous thrombosis (ASMVT) associated with bowel necrosis.

Authors: Kai Liu, Jiaxiang Meng, Shuofei Yang, Baochen Liu, Weiwei Ding, Xingjiang Wu and Jieshou Li

WSES position paper on vascular emergency surgery

Trauma, both blunt and penetrating, is extremely common worldwide, as trauma to major vessels. The management of these patients requires specialized surgical skills and techniques of the trauma surgeon. Furthe...

Authors: Bruno Monteiro T. Pereira, Osvaldo Chiara, Fabio Ramponi, Dieter G. Weber, Stefania Cimbanassi, Belinda De Simone, Korana Musicki, Guilherme Vieira Meirelles, Fausto Catena, Luca Ansaloni, Federico Coccolini, Massimo Sartelli, Salomone Di Saverio, Cino Bendinelli and Gustavo Pereira Fraga

Caustic ingestion management: world society of emergency surgery preliminary survey of expert opinion

Caustic material ingestion injuries (CMI) are uncommon. Only 5,000 cases are reported in the United States each year and most acute care healthcare facilities admit only a few cases annually. Accordingly, no s...

Authors: Yoram Kluger, Ofir Ben Ishay, Massimo Sartelli, Amit Katz, Luca Ansaloni, Carlos Augusto Gomez, Walter Biffl, Fausto Catena, Gustavo P. Fraga, Salomone Di Saverio, Augustin Goran, Wagih Ghnnam, Jeffry Kashuk, Ari Leppäniemi, Sanjay Marwah, Ernest E. Moore…

Etiology, treatment outcome and prognostic factors among patients with secondary peritonitis at Bugando Medical Centre, Mwanza, Tanzania

Secondary peritonitis due to perforation of the gastrointestinal tract is one of the most common surgical emergencies all over the world and is associated with significantly morbidity and mortality. Previous s...

Authors: Amri Mabewa, Jeremiah Seni, Phillipo L. Chalya, Stephen E. Mshana and Japhet M. Gilyoma

The limitations of using risk factors to screen for blunt cerebrovascular injuries: the harder you look, the more you find

Blunt cerebrovascular injury (BCVI) is reported to occur in 1–2 % of blunt trauma patients. Clinical and radiologic risk factors for BCVI have been described to help identify patients that require screening fo...

Authors: Lewis E. Jacobson, Mary Ziemba-Davis and Argenis J. Herrera

The importance of open emergency surgery in the treatment of acute mesenteric ischemia

Acute mesenteric ischemia (AMI) is a complex disease with a high mortality rate. A patient’s chance of survival depends on early diagnosis and rapid revascularization to prevent progression of intestinal gangr...

Authors: Mansur Duran, E. Pohl, K. Grabitz, H. Schelzig, T. A. Sagban and F. Simon

Foregut caustic injuries: results of the world society of emergency surgery consensus conference

Lesions of the upper digestive tract due to ingestion of caustic agents still represent a major medical and surgical emergency worldwide. The work-up of these patients is poorly defined and no clear therapeuti...

Authors: Luigi Bonavina, Mircea Chirica, Ognjan Skrobic, Yoram Kluger, Nelson A. Andreollo, Sandro Contini, Aleksander Simic, Luca Ansaloni, Fausto Catena, Gustavo P. Fraga, Carlo Locatelli, Osvaldo Chiara, Jeffry Kashuk, Federico Coccolini, Yuri Macchitella, Massimiliano Mutignani…

Evaluation of clotting factor activities early after severe multiple trauma and their correlation with coagulation tests and clinical data

Traumatic injuries are amongst the leading causes of death worldwide, frequently as a result of uncontrolled hemorrhage. Critical deficiencies in clotting factors have been noted in trauma-induced coagulopathy...

Authors: Manuel Burggraf, Arzu Payas, Max Daniel Kauther, Carsten Schoeneberg and Sven Lendemans

Epidemiology and socioeconomic features of appendicitis in Taiwan: a 12-year population-based study

This paper presents an epidemiologic study of appendicitis in Taiwan over a twelve-year period. An analysis of the incidence in the low-income population (LIP) is included to explore the effects of lower socio...

Authors: Kai-Biao Lin, K. Robert Lai, Nan-Ping Yang, Chien-Lung Chan, Yuan-Hung Liu, Ren-Hao Pan and Chien-Hsun Huang

Elevated white blood cell count, decreased hematocrit and presence of macrohematuria correlate with abdominal organ injury in pediatric blunt trauma patients: a retrospective study

Computerized tomography (CT) has become an important diagnostic modality in trauma patients. Pediatric patients are particularly susceptible to ionized radiation making liberal CT use in this age group unaccep...

Authors: Yehuda Hershkovitz, Sergei Naveh, Boris Kessel, Zahar Shapira, Ariel Halevy and Igor Jeroukhimov

World Society of Emergency Surgery-indication of globalism and renaissance through the 2015 biennial assembly

Authors: Yoram Kluger, Fausto Catena, Jeffry Kashuk and Luca Ansaloni

Liver trauma: WSES position paper

The liver is the most injured organ in abdominal trauma. Road traffic crashes and antisocial, violent behavior account for the majority of liver injuries. The present position paper represents the position of ...

Authors: Federico Coccolini, Giulia Montori, Fausto Catena, Salomone Di Saverio, Walter Biffl, Ernest E. Moore, Andrew B. Peitzman, Sandro Rizoli, Gregorio Tugnoli, Massimo Sartelli, Roberto Manfredi and Luca Ansaloni

WSES guidelines for management of Clostridium difficile infection in surgical patients

In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidenc...

Authors: Massimo Sartelli, Mark A. Malangoni, Fikri M. Abu-Zidan, Ewen A. Griffiths, Stefano Di Bella, Lynne V. McFarland, Ian Eltringham, Vishal G. Shelat, George C. Velmahos, Ciarán P. Kelly, Sahil Khanna, Zaid M. Abdelsattar, Layan Alrahmani, Luca Ansaloni, Goran Augustin, Miklosh Bala…

IROA: the International Register of Open Abdomen.

Actually the most common indications for Open Abdomen (OA) are trauma, abdominal sepsis, severe acute pancreatitis and more in general all those situations in which an intra-abdominal hypertension condition is...

Authors: Federico Coccolini, Fausto Catena, Giulia Montori, Marco Ceresoli, Roberto Manfredi, Gabriela Elisa Nita, Ernest E. Moore, Walter Biffl, Rao Ivatury, James Whelan, Gustavo Fraga, Ari Leppaniemi, Massimo Sartelli, Salomone Di Saverio and Luca Ansaloni

Trauma resuscitation requiring massive transfusion: a descriptive analysis of the role of ratio and time

We aimed to evaluate whether early administration of high plasma to red blood cells ratios influences outcomes in injured patients who received massive transfusion protocol (MTP).

Authors: Ruben Peralta, Adarsh Vijay, Ayman El-Menyar, Rafael Consunji, Husham Abdelrahman, Ashok Parchani, Ibrahim Afifi, Ahmad Zarour, Hassan Al-Thani and Rifat Latifi

The role of the open abdomen procedure in managing severe abdominal sepsis: WSES position paper

The open abdomen (OA) procedure is a significant surgical advance, as part of damage control techniques in severe abdominal trauma. Its application can be adapted to the advantage of patients with severe abdom...

Authors: Massimo Sartelli, Fikri M. Abu-Zidan, Luca Ansaloni, Miklosh Bala, Marcelo A. Beltrán, Walter L. Biffl, Fausto Catena, Osvaldo Chiara, Federico Coccolini, Raul Coimbra, Zaza Demetrashvili, Demetrios Demetriades, Jose J. Diaz, Salomone Di Saverio, Gustavo P. Fraga, Wagih Ghnnam…

Surgical management of AAST grades III-V hepatic trauma by Damage control surgery with perihepatic packing and Definitive hepatic repair–single centre experience

Severe liver injury in trauma patients still accounts for significant morbidity and mortality. Operative techniques in liver trauma are some of the most challenging. They include the broad and complex area, fr...

Authors: Krstina Doklestić, Branislav Stefanović, Pavle Gregorić, Nenad Ivančević, Zlatibor Lončar, Bojan Jovanović, Vesna Bumbaširević, Vasilije Jeremić, Sanja Tomanović Vujadinović, Branislava Stefanović, Nataša Milić and Aleksandar Karamarković

The selection of diagnostic modalities in the management of pelvic fracture patients requiring transfers

Pelvic fractures can result in life-threatening hemorrhages. Therefore, pelvic fracture patients must usually be transferred to a trauma center for additional management. We attempted to analyze transferred pe...

Authors: Chih-Yuan Fu, Shang-Ju Yang, Chien-Hung Liao, Being-Chuan Lin, Shih-Ching Kang, Shang-Yu Wang and Yu-Pao Hsu

The open abdomen, indications, management and definitive closure

The indications for Open Abdomen (OA) are generally all those situations in which is ongoing the development an intra-abdominal hypertension condition (IAH), in order to prevent the development of abdominal co...

Authors: Federico Coccolini, Walter Biffl, Fausto Catena, Marco Ceresoli, Osvaldo Chiara, Stefania Cimbanassi, Luca Fattori, Ari Leppaniemi, Roberto Manfredi, Giulia Montori, Giovanni Pesenti, Michael Sugrue and Luca Ansaloni

Maxillofacial and neck trauma: a damage control approach

Severe maxillofacial and neck trauma exposes patients to life threatening complications such as airway compromise and hemorrhagic shock. These conditions require rapid actions (diagnosis and management) and a ...

Authors: Amir A. Krausz, Michael M. Krausz and Edoardo Picetti

Severe mutilating injuries with complex macroamputations of the upper extremity – is it worth the effort?

An amputation of the upper extremity and the following replantation is still one of the most challenging operations in the field of reconstructive surgery, especially in extremely severe cases of combined muti...

Authors: Katrin Stanger, Raymund E. Horch and Adrian Dragu

Inferior vena cava enteric fistula due to unresected colorectal metastasis

A 57 year old male presented to our department with recurrent attacks of sepsis and upper gastrointestinal bleeding due to colorectal cancer metastasis that resulted in a fistula involving the inferior vena ca...

Authors: Hayim Gilshtein, Offir Ben-Ishay, Karina Nascovica and Yoram Kluger

One year experience of swine dermal non-crosslinked collagen prostheses for abdominal wall repairs in elective and emergency surgery

The approach to the abdominal wall surgical repair is dramatically changed in the last years. This study evaluates our institutional outcomes about the usage of biological meshes for abdominal wall repair in d...

Authors: Giulia Montori, Federico Coccolini, Roberto Manfredi, Marco Ceresoli, Luca Campanati, Stefano Magnone, Michele Pisano, Elia Poiasina, Gabriela Nita, Fausto Catena and Luca Ansaloni

Focused abdominal sonography for trauma in the clinical evaluation of children with blunt abdominal trauma

In pediatric care, the role of focused abdominal sonography in trauma (FAST) remains ill defined. The objective of this study was to assess the sensitivity and specificity of FAST for detecting free peritoneal...

Authors: Offir Ben-Ishay, Mai Daoud, Zvi Peled, Eran Brauner, Hany Bahouth and Yoram Kluger

Defining our destiny: trainee working group consensus statement on the future of emergency surgery training in the United Kingdom

The United Kingdom National Health Service treats both elective and emergency patients and seeks to provide high quality care, free at the point of delivery. Equal numbers of emergency and elective general sur...

Authors: A. E. Sharrock, V. J. Gokani, R. L. Harries, L. Pearce, S. R. Smith, O. Ali, H. Chu, A. Dubois, H. Ferguson, G. Humm, M. Marsden, D. Nepogodiev, M. Venn, S. Singh, C. Swain and J. Kirkby-Bott

Microbial colonization of open abdomen in critically ill surgical patients

This study was designed to describe the time-course and microbiology of colonization of open abdomen in critically ill surgical patients and to study its association with morbidity, mortality and specific comp...

Authors: Suvi Kaarina Rasilainen, Mentula Panu Juhani and Leppäniemi Ari Kalevi

Prediction of mortality in patients with colorectal perforation based on routinely available parameters: a retrospective study

Even after surgery and intensive postoperative management, the mortality rate associated with colorectal perforation is high. Identification of mortality markers using routinely available preoperative paramete...

Authors: Takehito Yamamoto, Ryosuke Kita, Hideyuki Masui, Hiromitsu Kinoshita, Yusuke Sakamoto, Kazuyuki Okada, Junji Komori, Akira Miki, Kenji Uryuhara, Hiroyuki Kobayashi, Hiroki Hashida, Satoshi Kaihara and Ryo Hosotani

Prediction of neurosurgical intervention after mild traumatic brain injury using the national trauma data bank

Patients with mild traumatic brain injury (TBI) as defined by an admission Glasgow Coma Score (GCS) of 14–15 often do not require neurosurgical interventions, but which patients will go on to require neurosurg...

Authors: Timothy E. Sweeney, Arghavan Salles, Odette A. Harris, David A. Spain and Kristan L. Staudenmayer

The duration of intra-abdominal hypertension strongly predicts outcomes for the critically ill surgical patients: a prospective observational study

Intra-abdominal hypertension (IAH) is associated with morbidity and mortality in critically ill patients. The present study analyzed the clinical significance of IAH in surgical patients with severe sepsis.

Authors: Kyu-Hyouck Kyoung and Suk-Kyung Hong

Factors affecting morbidity and mortality in traumatic colorectal injuries and reliability and validity of trauma scoring systems

This study aims to determine the factors that affect morbidity and mortality in colon and rectum injuries related with trauma, the use of trauma scoring systems in predicting mortality and morbidity.

Authors: Nurettin Ay, Vahhaç Alp, İbrahim Aliosmanoğlu, Utkan Sevük, Şafak Kaya and Bülent Dinç

Epidemiology of spinal injuries in the United Arab Emirates

To assess the risk factors, mechanism of injury, and clinical outcome of hospitalized patients with spinal injuries in order to recommend preventive measures.

Authors: Michal Grivna, Hani O. Eid and Fikri M. Abu-Zidan

Non operative management of traumatic esophageal perforation leading to esophagocutaneous fistula in pediatric age group: review and case report

Management of delayed presenting esophageal perforations has long been a topic of debate. Most authors consider definitive surgery being the management of choice. Management, however, differs in pediatric pati...

Authors: Biplab Mishra, Saurabh Singhal, Divya Aggarwal, Nitesh Kumar and Subodh Kumar

Benefits of WSES guidelines application for the management of intra-abdominal infections

The use of antibiotics is very high in the departments of Emergency and Trauma Surgery above all in the treatment of the intra-abdominal infections, to decrease morbidity and mortality rates; often the antimic...

Authors: Belinda De Simone, Federico Coccolini, Fausto Catena, Massimo Sartelli, Salomone Di Saverio, Rodolfo Catena, Antonio Tarasconi and Luca Ansaloni

Iatrogenic ureteric injuries following abdomino-pelvic operations: a 10-year tertiary care hospital experience in Tanzania

Iatrogenic ureteric injuries are rare complications of abdomino-pelvic surgery but associated with high morbidity and even mortality. There is paucity of data regarding iatrogenic ureteric injuries in Tanzania...

Authors: Phillipo L Chalya, Anthony N Massinde, Albert Kihunrwa and Samson Simbila

Laparoscopic surgery in abdominal trauma: a single center review of a 7-year experience

Laparoscopic surgery has greatly improved surgical outcome in many areas of abdominal surgery. But many concerns of safety have limited its application in abdominal trauma. We hypothesized that laparoscopy cou...

Authors: Kyoung Hoon Lim, Bong Soo Chung, Jong Yeol Kim and Sung Soo Kim

Non-heparinized ECMO serves a rescue method in a multitrauma patient combining pulmonary contusion and nonoperative internal bleeding: a case report and literature review

Pulmonary contusion and acute respiratory distress syndrome (ARDS) is a common manifestation in polytraumatic patients. Although mechanical ventilation is still the first choice of treatment, a group of patien...

Authors: Pei-Hung Wen, Wai Hung Chan, Ying-Cheng Chen, Yao-Li Chen, Chien-Pin Chan and Ping-Yi Lin