The case was a 9-year-old boy. He fell while cycling and was transported to a nearby hospital. In this previous hospital, liver damage III b (Japan Trauma Society liver damage classification) was found by abdominal enhanced computed tomography (CT). His systolic blood pressure decreased to 60mmHg in the ambulance during transportation to our emergency and critical care center. Because of this hemodynamic instability, we decided on emergency open surgery and damage control surgery. We undertook TAE to stop the continuous bleeding that had lasted for 2 postoperative days. We closed the abdominal wall on the 6th postoperative day and discharged him on the 17th postoperative day. We thought that precise inspection and rapid decision are important when abdominal organ damage is predicted in children with upper abdominal pain due to bicycle handle trauma. Language: ja
We treated a case of traumatic extraperitoneal bladder rupture and achieved a good clinical outcome via surgical operation. The patient, a 70-year-old female, had jumped from the 2nd floor of a building in order to commit suicide. Contrast computed tomography images showed disruption of the bladder wall, and extravasation of contrast medium was observed. After tests, the vital signs showed that the patient had gone into shock, and emergency surgery was performed. We repaired an 8-cm-long injury of the anterior bladder wall. The postoperative course was favorable. A contrasted cystogram was obtained 3 weeks postoperatively. We confirmed that there was no leakage of contrast medium from the bladder wall. The patient had extraperitoneal bladder rupture complicating a pelvic fracture, and a pessary may have caused enlargement of the injury site. We selected surgical operation for this case of extraperitoneal bladder rupture and achieved a favorable clinical outcome. Language: ja
This research aimed to propose a logistic regression model for Japanese blunt trauma victims. First, we tested whether the logistic regression model previously created from data registered in the Japan Trauma Data Bank (JTDB) between 2005 and 2008 is still valid for the data from JTDB between 2009 and 2013. The model was proved to be highly accurate (94.56%) and valid. We also demonstrated that the model remains valid without respiratory rate (RR) data. In addition, we demonstrated that the model would maintain high accuracy even when its coefficients were rounded off to two decimal places. As a result of our investigation, we propose the equation of survival prediction in Japan to be Ps=1/ (1+e-b) b=-0.76+1.03×Revised Trauma Score-0.07×Injury Severity Score-0.04×age. Language: ja
