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Splenic injury case

Duchesne, Juan C jduchesn at tulane.edu
Sun Dec 28 16:37:19 GMT 2014

Dr Giovanni- I personally use the ABC score for MTP but its really cool to
see the TASH SCORE still in use! I like it personally but it takes a
calculator to do the prediction


"Everyday I do my best not to be averageŠŠ"

Juan Duchesne, MD, FACS, FCCP, FCCM
Trauma Medical Director
GME Medical Director
North Oaks Health System, Hammond LA

Clinical Associate Professor of Surgery
Tulane University, 
New Orleans LA
LSUHSC, New Orleans LA
Chairman, Louisiana Committee of Trauma

Trauma Program
15790 Paul Vega MD Dr.
Hammond, La 70403
Office 230-2476 | Fax 230-2478

On 12/28/14 12:18 AM, "Bellanova Giovanni" <giovanni.bellanova at apss.tn.it>

>Hello everyone, at the entrance to the emergency room, the patient had a
>bordeline hemodynamic status (HR 120 BP 90/60 - i) but I believe that in
>the absence of signs of peritonism with a good response after fluid or
>hemostatic resuscitation (TASH SCORE?), I would avoid surgery in favor of
>non-operative management and embolization, reserving laparotomy in case
>of failure.
>dr. Giovanni Bellanova
>Surgery 2nd Division
>S.Chiara Hospital Trento
>tel. +390461903816 -3239
>fax +390461903735
>mob +393382420241
>Da: trauma-list-bounces at trauma.org [trauma-list-bounces at trauma.org] per
>conto di Timothy Hardcastle [Hardcastle at ukzn.ac.za]
>Inviato: domenica 28 dicembre 2014 6.12
>A: Trauma-List [TRAUMA.ORG]
>Oggetto: RE: Splenic injury case
>Hi Gad
>Provided she is evaluable (GCS good, above 12) and you can do serial Hb,
>Lactate etc, plus review her regularly. This may be difficult in some
>settings. As Juan has mentioned the seat-belt scar is also a confounder.
>Dr Timothy Hardcastle
>MB,ChB(Stell); M.Med(Chir)(Stell); PhD, FCS(SA), Trauma Surgery(HPCSA)
>Head: UKZN Trauma Surgery Training Unit
>Deputy Director: IALCH Trauma Service and Trauma ICU
>Hardcastle at ukzn.ac.za / timothyhar at ialch.co.za
>Mobile +27824681615
>Postal: PostNet 27, Private Bag X05, MALVERN, 4055
>Durban, South Africa
>-----Original Message-----
>From: trauma-list-bounces at trauma.org
>[mailto:trauma-list-bounces at trauma.org] On Behalf Of Gad Shaked
>Sent: 27 December 2014 21:35
>To: Trauma-List [TRAUMA.ORG]
>Subject: RE: Splenic injury case
>The patient responded well to resus. Was stable enoug to undergo CT scan,
>no contrast material extravasation, no other injury detected. She is a
>good candidate to non operative management regardless her grade of
>injury, which may be upgraded by the CT reading. Surgery if she becomes
>unstable or shows signs of peritonitis during surveillance.
>Gad Shaked
>Prof. of Surgery
>Soroka University Medical Center
>Ben-Gurion University
>Beer Sheva
>Tel. 972 54 2365600
>From: trauma-list-bounces at trauma.org [trauma-list-bounces at trauma.org] on
>behalf of Miklosh Bala [mikloshbala at gmail.com]
>Sent: Saturday, December 27, 2014 10:31
>To: trauma-list at trauma.org
>Subject: Splenic injury case
>22 yo female following car crush, on arrival HR 120, BP 90/60, seatbelt
>sign and posterior hip dislocation. Following resuscitation
>(crystalloids) and hip reduction, CT showed splenic rupture (Grade 4) -no
>active contrast extravasation.
>BP 100' HP 100. No other injury.
>The patient 2 years following Sleeve Gastrectomy.
>Do you thing angio is safe for this specific case? Short gastric arteries
>are divided - is that come to consideration?
>Miklosh Bala, MD
>Head of Trauma and Acute Care Surgery Unit Hadassah - Hebrew University
>Medical Center
>Tel: (972) 26778800; Fax: (972) 26449412
>Email: mikloshbala at gmail.com
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