Rib fractures and their association With solid organ injury: higher rib fractures have greater significance for solid organ injury screening.


BACKGROUND:The purpose of this study was to identify patients with rib injuries who were at risk for solid organ injury. METHODS:A retrospective chart review was performed of all blunt trauma patients with rib fractures during the period from July 2007 to July 2012. Data were analyzed for association of rib fractures and solid organ injury. RESULTS:In all, 1,103 rib fracture patients were identified; 142 patients had liver injuries with 109 (77%) associated right rib fractures. Right-sided rib fractures with highest sensitivity for liver injury were middle rib segment (5 to 8) and lower segment (9 to 12) with liver injury sensitivities of 68% and 43%, respectively (P < .001); 151 patients had spleen injuries with 119 (79%) associated left rib fractures. Left middle segment rib fractures and lower segment rib fractures had sensitivities of 80% and 63% for splenic injury, respectively (P < .003). CONCLUSIONS:Rib fractures higher in the thoracic cage have significant association with solid organ injury. Using rib fractures from middle plus lower segments as indication for abdominal screening will significantly improve rib fracture sensitivity for identification of solid organ injury.


Am J Surg


Rostas JW,Lively TB,Brevard SB,Simmons JD,Frotan MA,Gonzalez RP




Has Abstract


2017-04-01 00:00:00














  • National trends in total vs subtotal gastrectomy for middle and distal third gastric cancer.

    abstract:BACKGROUND:To identify trends in total and subtotal gastrectomy for middle and distal third gastric adenocarcinoma in the U.S. METHODS:NCDB was queried for patients with stage 0-III middle or distal gastric adenocarcinoma treated with total or subtotal gastrectomy. Statistical analysis including cox proportional hazar...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Ju T,Rivas L,Kurland K,Chen S,Sparks A,Lin PP,Vaziri K

    更新日期:2020-04-01 00:00:00

  • Tachykinins in the canine gastroesophageal junction.

    abstract::Lower esophageal sphincter (LES) effects produced by the mammalian tachykinins were evaluated in anesthetized dogs. The distribution and content of substance P (SP) and neurokinin A (NKA) in the region of the canine gastroesophageal junction was also studied. SP and NKA stimulated a linear dose-dependent contraction o...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Sandler AD,Maher JW,Weinstock JV,Schmidt CD,Schlegel JF,Jew JY,Williams TH

    更新日期:1991-01-01 00:00:00

  • Pyogenic hepatic abscess with biliary communication.

    abstract:BACKGROUND:The aims of this study were to compare the effectiveness of percutaneous drainage between pyogenic hepatic abscesses with and those without biliary communication and to evaluate the role of endoscopic biliary stent placement in the treatment of communicating abscesses. METHODS:Sixty-one patients with hepati...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Sugiyama M,Atomi Y

    更新日期:2002-02-01 00:00:00

  • Survival and quality of life after organ transplantation in veterans and nonveterans.

    abstract:BACKGROUND:Some previous studies suggested that transplantation performed in Department of Veterans Affairs (VA) patients was associated with a higher rate of complications and poorer outcomes. We examined more than a decade of experience with solid organ transplantation at a single center and compared VA patients with...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Moore D,Feurer I,Speroff T,Shaffer D,Nylander W,Kizilisik T,Butler J,Awad J,Gorden DL,Chari R,Wright JK,Pinson CW

    更新日期:2003-11-01 00:00:00

  • When patients call their surgeon's office: an opportunity to improve the quality of surgical care and prevent readmissions.

    abstract:BACKGROUND:Little is known about care coordination and communication with outpatient endocrine surgery patients. This study evaluated phone calls between office nurses and surgical patients to identify common issues addressed and their effect on patient care. METHODS:Qualitative analysis of preoperative and postoperat...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Brekke A,Elfenbein DM,Madkhali T,Schaefer SC,Shumway C,Chen H,Schneider DF,Sippel RS,Balentine C

    更新日期:2016-03-01 00:00:00

  • Pancreatoduodenectomy using a no-touch isolation technique.

    abstract:BACKGROUND:Pancreatoduodenectomy is the only effective treatment for cancers of the periampullary region. Because surgeons usually grasp tumors during pancreatoduodenectomy, this procedure may increase the risk of squeezing and shedding the cancer cells into the portal vein, retroperitoneum, and/or peritoneal cavity. I...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Hirota M,Kanemitsu K,Takamori H,Chikamoto A,Tanaka H,Sugita H,Sand J,Nordback I,Baba H

    更新日期:2010-05-01 00:00:00

  • Role of intraoperative pancreatography in patients with injury to the pancreas.

    abstract::Over a 10 year period, 54 patients presented with pancreatic trauma. During the first 5 years of the study, when pancreatography was not utilized for the assessment of pancreatic duct injury, 55 percent of the patients had major pancreatic complications. During the subsequent 5 years, suspected proximal duct injury wa...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Berni GA,Bandyk DF,Oreskovich MR,Carrico CJ

    更新日期:1982-05-01 00:00:00

  • Individualized, targeted wound treatment based on the tissue bacterial level as a biological marker.

    abstract:BACKGROUND:The use of biologic markers to aid in individualizing wound treatment may help improve outcomes. A biologic marker that has been demonstrated to be predictive of healing in both chronic and acute wounds is wound tissue bacterial level. The objective of this study was to determine whether tissue bacterial lev...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Pierpont YN,Uberti MG,Ko F,Robson MC,Smith CA,Wright TE,Payne WG

    更新日期:2011-08-01 00:00:00

  • Screening for lower extremity deep venous thrombosis. An improved plethysmographic and Doppler approach.

    abstract::Noninvasive screening of the lower extremities for deep vein thrombosis was performed bilaterally on 1,118 patients. Impedance plethysmography alone was used in 868. Venography in 135 revealed an accuracy of 88%, with a false-negative rate of 5.3% and a false-positive rate of 18.6%. A combined ultrasonic Doppler and m...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Lepore TJ,Savran J,Van De Water J,Harrower HW,Yablonski M

    更新日期:1978-04-01 00:00:00

  • Tumor DNA content as a prognostic indicator in squamous cell carcinoma of the head and neck region.

    abstract::Our purpose in this study was to determine whether tumor DNA content is a prognostic factor independent of other standard clinical and histologic parameters in squamous cell carcinoma (SCC) of the head and neck region. Tumor DNA content was determined in 76 patients with primary resectable SCC of the oral cavity, lary...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Kokal WA,Gardine RL,Sheibani K,Zak IW,Beatty JD,Riihimaki DU,Wagman LD,Terz JJ

    更新日期:1988-10-01 00:00:00

  • Limited efficacy of early postoperative jejunal feeding.

    abstract::Twenty patients underwent placement of a jejunal catheter for early postoperative feeding at the time of upper abdominal operations, and a control group of 11 patients underwent operative procedures of similar magnitude without jejunostomy. Advancement of the rate of feeding to target intake over 6 to 7 days was attem...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Hayashi JT,Wolfe BM,Calvert CC

    更新日期:1985-07-01 00:00:00

  • Screening cervical spine MRI after normal cervical spine CT scans in patients in whom cervical spine injury cannot be excluded by physical examination.

    abstract:BACKGROUND:Cervical spine injuries can occur in as many as 10% of patients with blunt trauma with mental status changes from closed head injuries. Despite normal results on cervical spine computed tomography (CT), magnetic resonance imaging (MRI) is often recommended to exclude ligamentous or soft tissue injury. METHO...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Steigelman M,Lopez P,Dent D,Myers J,Corneille M,Stewart R,Cohn S

    更新日期:2008-12-01 00:00:00

  • Overseas organ donation during wartime operations: Benchmarking military performance against civilian practice.

    abstract:BACKGROUND:Over the past 15 years of war, eligible U.S. military members donated organs overseas in Germany. Our hypothesis was that outcomes at a military treatment facility were comparable to a civilian cohort. METHODS:Military donors were matched 1:3 with a donor cohort from the U.S. United Network for Organ Sharin...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Oh JS,Malinoski D,Martin KD,De La Cruz JS,Zonies D

    更新日期:2017-08-01 00:00:00

  • Advanced squamous cell carcinoma of the maxillary sinus. Results of combined regional infusion chemotherapy, radiation therapy and surgery.

    abstract::Sequential intraarterial chemotherapy using bleomycin and methotrexate followed by high dose radiation and surgery was evaluated in 10 patients with stage III and IV squamous carcinomas of the maxillary sinus. Seven of 10 patients had extensive tumor necrosis in the surgical specimen, and no evidence of residual tumor...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Moseley HS,Thomas LR,Everts EC,Stevens KR,Ireland KM

    更新日期:1981-05-01 00:00:00

  • New break-away needle for subclavian vein cannulation.

    abstract::A new break-away needle for subclavian catheter insertion has been described. This needle functions exactly as the usual 14 gauge needle, but it can be completely removed from the catheter while leaving the integral Luer adaptor intact. ...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Crowley WC,Klein MD

    更新日期:1984-06-01 00:00:00

  • Revisiting the "10% rule" in breast cancer sentinel lymph node biopsy: an approach to minimize the number of sentinel lymph nodes removed.

    abstract:BACKGROUND:Sentinel lymph node (SLN) biopsy (SLNB) is an accurate and proven axillary staging procedure for early breast cancer. The aim of this study was to determine if the "10% rule" is applicable to the performance of SLNB at the investigators' institution and if the criteria used for SLNB at their institution coul...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Dutta R,Kluftinger A,MacLeod M,Kindrachuk G,Baliski C

    更新日期:2012-05-01 00:00:00

  • Impaired clearance of Escherichia coli bacteremia in early biliary obstruction.

    abstract::Adult male rats underwent common bile duct ligation or sham celiotomy. At intervals of 7 and 14 days postoperatively, bacteremia was induced by intravenous injection of 10(9) Escherichia coli or intraperitoneal injection of 10(6) E. coli. Serial quantitative blood cultures and quantitative whole organ cultures were ob...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Scott-Conner CE,Grogan JB,Scher KS,Bernstein J

    更新日期:1989-02-01 00:00:00

  • Rapid long tube intubation of the jejunum by a new endoscopic device.

    abstract::Despite the advantages of aseptic nonoperative intubation of the small intestine for decompression of obstructed loops, 48% of the attempts lead to failure to pass the tube through the pylorus. The difficulty and inconvenience of passage beyond the stomach have been overcome by the development of a special tube attach...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Johnson FW,Goodale RL,Leonard AS,Varco RL

    更新日期:1976-01-01 00:00:00

  • Educational intervention is effective in improving knowledge and confidence in surgical ethics-a prospective study.

    abstract:BACKGROUND:Professionalism and ethics are Accreditation Council for Graduate Medical Education (ACGME) core competencies, but there is little evidence regarding the effectiveness of ethics education. METHODS:General surgery residents at the University of Pittsburgh completed questionnaires measuring attitudes and know...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Thirunavukarasu P,Brewster LP,Pecora SM,Hall DE

    更新日期:2010-11-01 00:00:00

  • Impact of gender and body surface area on outcome after abdominal aortic aneurysm repair.

    abstract:BACKGROUND:A gender-neutral threshold aneurysm diameter (AD) of more than 5.5 cm for surgical intervention in abdominal aortic aneurysms (AAA) ignores the fact that women have a smaller baseline AD. We hypothesized that women have a greater AD relative to body surface area (BSA) at the time of surgery and that this wor...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Matyal R,Shakil O,Hess PE,Lo R,Jainandunsing JS,Mahmood B,Hartman GS,Schermerhorn ML,Mahmood F

    更新日期:2015-02-01 00:00:00

  • Burnout and its relationship with perceived stress, self-efficacy, depression, social support, and programmatic factors in general surgery residents.

    abstract:BACKGROUND:Burnout affects surgical residents' well-being. OBJECTIVE:We sought to identify factors associated with burnout among surgery residents. METHODS:An electronic/anonymous survey was sent to surgical residents at 18 programs, consisting of demographic/programmatic questions and validated scales for burnout, d...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Smeds MR,Janko MR,Allen S,Amankwah K,Arnell T,Ansari P,Balters M,Hess D,Ferguson E,Jackson P,Kimbrough MK,Knight D,Johnson M,Porter M,Shames BD,Schroll R,Shelton J,Sussman J,Yoo P

    更新日期:2020-06-01 00:00:00

  • Meet your surgical team: The impact of a resident-led quality improvement project on patient satisfaction.

    abstract:BACKGROUND:Patients often have an incomplete understanding of the levels of training and roles of the various surgical providers in teaching hospitals, leading to patient confusion and dissatisfaction. METHODS:Pre-intervention discharge surveys were administered to gastrointestinal surgery inpatients (10/2016-02/2017)...

    journal_title:American journal of surgery

    pub_type: 临床试验,杂志文章


    authors: Craig-Schapiro R,DiBrito SR,Overton HN,Taylor JP,Fransman RB,Haut ER,Sacks BC

    更新日期:2018-10-01 00:00:00

  • Trends in blood pressure-related outcomes after adrenalectomy in patients with primary aldosteronism: A systematic review.

    abstract:BACKGROUND:Decrease in blood pressure (BP) is the major goal of adrenalectomy for primary aldosteronism. Nevertheless, the optimal timing to assess these outcomes and the needed duration of follow-up are uncertain. We systematically reviewed the literature regarding trends in BP-related outcomes during follow-up after ...

    journal_title:American journal of surgery

    pub_type: 杂志文章,评审


    authors: Suurd DPD,Vorselaars WMCM,Van Beek DJ,Spiering W,Borel Rinkes IHM,Valk GD,Vriens MR

    更新日期:2020-12-03 00:00:00

  • Does neomucosa induced by small bowel stem cell transplantation have adequate function?

    abstract::Small intestinal epithelium digests and absorbs nutrients. Crypt stem cell transplantation can generate neomucosa with normal morphology, but the digestive and absorptive capacities of this neomucosa are unknown. This study evaluates stem cell induced neomucosal brush border digestive enzyme activity and nutrient tran...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Tait IS,Penny JI,Campbell FC

    更新日期:1995-01-01 00:00:00

  • T-lymphocyte levels in the peripheral blood of patients with cancer of the head and neck.

    abstract::Percentage and levels of circulating T-lymphocytes were studied in forty-six patients with squamous cell carcinoma of the head and neck before and/or after treatment and compared with control values obtained in fifty-one healthy volunteers. Mean percentages of circulating T-cells and mean T-cell levels in cancer patie...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Olkowski ZL,Wilkins SA Jr

    更新日期:1975-10-01 00:00:00

  • Didactic lecture versus instructional standardized patient interaction in the surgical clerkship.

    abstract:BACKGROUND:Medical schools increasingly employ the standardized patient interaction (SPI) as a teaching and testing modality to prepare students for USMLE Step 2 Clinical Skills (Step 2 CS). However, little is known about the perceptions medical students have toward SPIs. We hypothesized that the SPI would increase the...

    journal_title:American journal of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Carter MB,Wesley G,Larson GM

    更新日期:2005-02-01 00:00:00

  • A new vagal anchor electrode for real-time monitoring of the recurrent laryngeal nerve.

    abstract:BACKGROUND:Despite conventional neuromonitoring, the recurrent laryngeal nerve (RLN) is still at risk for damage during thyroid surgery. The feasibility of continuous RLN monitoring by vagal nerve (VN) stimulation with a new anchor electrode should be shown, and electromyographic signal alterations of stressed RLN were...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Schneider R,Przybyl J,Pliquett U,Hermann M,Wehner M,Pietsch UC,König F,Hauss J,Jonas S,Leinung S

    更新日期:2010-04-01 00:00:00

  • A meta-analysis of the efficacy of prophylactic alpha-blockade for the prevention of urinary retention following primary unilateral inguinal hernia repair.

    abstract:BACKGROUND:Urinary retention following inguinal hernia surgery is common and is believed to be associated with adrenergic over-stimulation of the smooth muscle in the bladder neck and prostate. The efficacy of prophylactic alpha-blockade in the prevention of urinary retention following elective inguinal hernia repair i...

    journal_title:American journal of surgery

    pub_type: 杂志文章,meta分析,评审


    authors: Clancy C,Coffey JC,O'Riordain MG,Burke JP

    更新日期:2018-08-01 00:00:00

  • Presidential address: imagination trumps knowledge.

    abstract::Multiple organ failure (MOF) emerged 30 years ago and became our research focus. Over the years, we have proposed a series of cartoons that rallied multidisciplinary translational research teams around common themes to generate "win-win" hypotheses that when tested (right or wrong) have advanced our understanding of M...

    journal_title:American journal of surgery



    authors: Moore FA

    更新日期:2010-12-01 00:00:00

  • Pitfalls in the management of penetrating chest trauma.

    abstract::A prospective study designed specifically to analyze errors in management and iatrogenic complications was conducted on 234 consecutive patients with penetrating chest trauma. Eleven percent of penetrating pleural injuries were incorrectly diagnosed on initial physical and radiologic examination, but this led to wrong...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Hirshberg A,Thomson SR,Bade PG,Huizinga WK

    更新日期:1989-04-01 00:00:00