Gerald W. Shaftan

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OBJECTIVES The aims of this study were to determine if angiographic findings can be used to predict successful nonoperative therapy of splenic injury and to determine if coil embolization of the proximal splenic artery provides effective hemostasis. METHODS Splenic injuries detected by diagnostic imaging between 1981 and 1993 at a level I trauma center(More)
Vertical deceleration injuries represent a distinct form of urban blunt trauma. We reviewed 161 adult patients, admitted over 36 months, who jumped or fell from a height of one to seven stories and survived emergency department resuscitation. Charts and radiographs were analyzed to identify common injuries, complications, and causes of death. Those who fell(More)
Injury of the lumbar arteries is a cause of potentially life-threatening retroperitoneal hemorrhage. Twelve patients who sustained massive hemorrhage of the lumbar arteries associated with lumbar spinal fractures and/or pelvic fractures are described. Computed tomography (CT) was helpful by revealing a distinct separation of the lumbar hemorrhage from the(More)
Background: Perforated appendicitis is associated with a significant risk of postoperative abdominal and wound infection. Only a few controversial studies evaluate the role of laparoscopy in perforated appendicitis. The significance of conversion from laparoscopy to open appendectomy for perforated appendicitis is not well defined. Statistical analysis was(More)
Major injury leads to impaired immune responses and increases the risk of infectious complications. Following trauma, increased prostaglandin E2 (PGE2) levels may be important in immunodysregulation. We hypothesized that blocking PGE2 with NS-398, a selective COX-2 inhibitor, during the first 24 h after injury may modify the immune response and protect the(More)
The effectiveness of transcatheter embolization was studied prospectively from January 1977 through July 1984 in 31 patients with extensive pelvic fractures, hypotension, and large retroperitoneal hematomas. The indications for angiography in patients with pelvic fractures included: four or more units of blood transfusion within 24 hours, six or more units(More)
Geriatric trauma survival rates are reported to approach 85%, but no series to our knowledge has included a predominance of multiply injured patients. In 1985, we treated 60 patients more than 65 years of age who sustained blunt multiple trauma, excluding burns and minor falls. A pedestrian-motor vehicle mechanism, initial BP less than 150 mm Hg, acidosis,(More)
Intra-aortic balloon occlusion (IABO) of the thoracic aorta was attempted in 21 consecutive hemodynamically unstable patients with missile injuries of the abdomen. Retrospectively, the patients fell into three groups. Group One consisted of five patients with a cardiac rhythm but no recordable blood pressure (BP). Group Two were six patients with refractory(More)
I N general, traumatic wound therapy in civilians foIIows military practice. After WorId War II it was inevitabIe that the war time management of abdominal wounds should carry over into the peace time emergency rooms and operating theaters. The miIitary practice of routineIy performing earIy expIoration was based on the almost uniformly fatal outcome of(More)
An accurate method of estimating acute blood loss is essential in the evaluation of injured patients. Central venous oxygen (CVO2) saturation has been shown to be a sensitive and reliable correlate of blood loss in an animal model but its clinical validity is unproven. We evaluated 26 consecutive patients with an injury mechanism suggesting blood loss but(More)