Ari Leppäniemi

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Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have been increasingly recognized in the critically ill over the past decade. The variety of definitions proposed has led to confusion and difficulty in comparing one study to another. An international consensus group of critical care specialists convened at the second World(More)
BACKGROUND The optimal strategy for identifying patients with abdominal stab wounds requiring surgical repair has not been defined. The potential benefits of diagnostic laparoscopy by incorporating it into the routine diagnostic workup of patients with anterior abdominal stab wounds was evaluated in a two-layer, randomized study. METHODS From May 1997(More)
BACKGROUND Several temporary abdominal closure techniques have been used in the management of open abdomen. Failure to achieve delayed primary fascial closure results in a large ventral hernia. This retrospective analysis evaluated whether the use of vacuum-assisted closure and mesh-mediated fascial traction (VACM) as temporary abdominal closure improved(More)
The incidence of intra-abdominal hypertension (IAH) in patients with severe acute pancreatitis (SAP) is approximately 60–80%. It is usually an early phenomenon, partly related to the effects of the inflammatory process, causing retroperitoneal edema, fluid collections, ascites, and ileus, and partly iatrogenic, resulting from aggressive fluid resuscitation.(More)
OBJECTIVE To compare three different multiple organ dysfunction scores in predicting hospital mortality rates and to discover which one best assesses organ dysfunction/failure in patients with severe acute pancreatitis in a general intensive care unit. DESIGN Retrospective, observational study. SETTING Surgical department and a ten-bed general intensive(More)
Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have been increasingly recognized in the critically ill over the past decade. In the absence of consensus definitions and treatment guidelines the diagnosis and management of IAH and ACS remains variable from institution to institution. An international consensus group of(More)
OBJECTIVE To investigate whether marker(s) of systemic inflammation detect, at an early stage of acute pancreatitis, patients who may ultimately develop severe disease. DESIGN Prospective study. SETTING University hospital emergency unit. PATIENTS Thirty patients with mild acute pancreatitis (SEV0 group) and 27 with severe acute pancreatitis. Of the(More)
PURPOSE OF REVIEW The purpose of this review is to evaluate the current state and recent developments of trauma systems in Europe. RECENT FINDINGS The introduction of a pilot trauma system in the United Kingdom seemed to halve the mortality rate in 6 years. This improvement was thought to result, at least in part, from improved patient care. A comparison(More)
The rich and diverse heritage of the management of vascular injuries in the 45 independent European countries prevents the authors from revealing a uniform picture of the European experience, but some trends are clearly emerging. In countries with a low incidence of penetrating trauma and increasing use of interventional vascular procedures, the proportion(More)
Laparostomy is a surgical treatment method in which the peritoneal cavity is opened anteriorly and deliberately left open, hence often called `open abdomen’. Th e abdominal contents are exposed and protected with a temporary coverage. Th e term does not include full-thickness abdominal wall defects resulting from partial excision due to tumor or necrotizing(More)