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Biomedical subjects

Pål Aksel Naess

Publications and source records attributed to Pål Aksel Naess.

6 recordsLinked to original sources

[Treatment of splenic injuries in children].

BACKGROUND: Most children with blunt splenic trauma are treated non-operatively. Controversy exists regarding the minimal hospital stay, follow-up imaging and length of activity restriction required after discharge. MATERIAL AND METHODS: To evaluate outcome for this group of patients, a review was performed of children (age below 14) with blunt splenic injuries treated between January 2000 and December 2003. RESULTS: Fifteen children were admitted with blunt splenic trauma, all were successfully treated non-operatively. Four patients were excluded from further analysis because of multiple injuries that prolonged their hospital stay or they were transferred to our institution more than six days after the accident. Median age was 8 years (range, 1-12). Median length of stay was 5 days (range, 3-8) including 0 days (range, 0-4) in the intensive care unit. Median numbers of follow-up ultrasound examinations were 2 (range, 0-4) with no influence on treatment. Reduced activity after discharge was advised for a median of 4 weeks (3-6). All patients had an uneventful recovery. INTERPRETATION: Haemodynamically stable children with blunt splenic injuries can be treated non-operatively with short hospital stay and a few weeks of restricted activity after discharge. Routine follow-up imaging seems unnecessary.

Child↗

[Pseudoaneurysm in splenic injury].

Blunt splenic injuries are increasingly being managed non-operatively. Consequently, radiological examinations in the follow up of these injuries must aim at detecting lesions like pseudoaneurysms that can cause delayed bleeding. Two patients are presented. They were both diagnosed at a local hospital and treated at the regional trauma centre. In both patients pseudoaneurysms were detected on CT examination with arterial contrast phase. Angiographic embolisation was performed successfully. The cases are discussed with reference to relevant literature. Pseudoaneurysms may not be detected at the initial CT scan and can cause delayed bleeding. Thus it seems wise to perform a CT scan in arterial and venous contrast phase 5-7 days after the injury. Interventional angiography should be offered haemodynamically stable adult patients with serious splenic injury and in the absence of other indications for laparotomy.

Adolescent↗

[Vacuum pack technique--a good method for temporal abdominal closure].

UNLABELLED: Abdominal compartment syndrome(ACS) is a clinical entity characterised by increased intraabdominal pressure leading to multiple organ failure, fatal if left untreated. The treatment of abdominal compartment syndrome is surgical decompression with a temporary abdominal wall substitute. To avoid the development of abdominal compartment syndrome, temporary abdominal closure (TAC) should be considered after celiotomy for trauma. A new method for TAC was introduced at Ullevaal University Hospital in 2002, the "vac pac". METHOD: The "vac pac" technique is described and the patients treated with "vac pac" during the first year after introduction are presented. RESULTS: Five patients were treated using the "vac pac". One patient had acute pancreatitis and developed abdominal compartment syndrome. The other patients were severely injured and the indication for TAC was abdominal compartment syndrome in one patient, intestinal oedema in another, and damage control surgery with packing in two patients. Delayed primary closure was achieved within five days in all our patients. There were no fatalities and no complications related to the use of "vac pac" were registered. CONCLUSION: The "vac pac" technique seems to be a good method for TAC.

Abdominal Injuries↗

[Laparoscopic treatment of splenic cysts].

Splenic cysts are uncommon. The symptoms are usually vague, but complications such as haemorrhage, rupture and infection may occur. The majority of splenic cysts are seen in children and young adults. Surgical treatment is recommended and splenic preservation is advantageous. We present two patients with splenic cysts successfully treated with laparoscopic resection of the cyst wall.

Adolescent↗

Complications of umbilical vein catheterization: neonatal total parenteral nutrition ascites after surgical repair of congenital diaphragmatic hernia.

A 2-day-old girl was admitted to surgery for repair of a left-sided diaphragmatic hernia (CDH). Preoperatively, an umbilical vein catheter (UVC) was inserted with the tip in the left hypochondrium. The UVC tip position was unchanged radiographically peroperatively. At the fifth postopertive day abdominal distension and signs of gastric outlet obstruction appeared. Explorative laparotomy found liver necrosis at the site of the catheter tip and parenteral nutrition ascites.

Ascites↗