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32 years old&#59; no significant clinical history&#59; the driver was wearing a helmet and suffered from high-energy trauma due to motorcycle crash with further ejection from the vehicle&#46; After initial assessment following the ATLS principles and confirmation of airway patency&#59; good ventilation&#59; hemodynamic stability&#59; and absence of severe CET&#44; the patient was transferred to a trauma reference center&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">We conducted the initial assessment upon arrival&#58; patient alert&#44; oriented&#44; and speaking in a coherent manner&#46; Good airway patency with cervical protection&#59; spontaneous respiration rate at 18<span class="elsevierStyleHsp" style=""></span>bpm&#59; symmetrical respiratory movement pattern&#59; absence of external signs of cervical and thoracic lesions&#59; and normal percussion&#44; and lung auscultation&#46; The patient remains hemodynamically normal at 80<span class="elsevierStyleHsp" style=""></span>bpm&#59; 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and no signs of lateralization or spine injury&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The secondary survey analyzed the skin surface&#44; and cleaned and sutured wounds in the lower lip region&#59; jaw&#59; right forearm&#59; and right ankle&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">In this context&#44; we conducted one <span class="elsevierStyleItalic">total-body CT scan</span> that found multiple lesions&#58; rupture of the descending thoracic aorta type IV with pseudoaneurysm&#59; periaortic hematoma&#59; small left hemithorax &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#59; posterior splenic lacerations grade II&#59; hepatic lacerations grade II in segment V with signs of active bleeding &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>A&#41;&#59; right posterior&#8211;superior renal laceration grade IV &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>B&#41;&#59; and gallbladder microperforation grade I&#46; There was no damage to the axial skeleton or the pelvic girdle&#44; but there were left and sternal nondisplaced mandibular fractures&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">The urgent percutaneous placement of one aortic endoprosthesis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C&#41; followed by hepatic&#44; renal&#44; and splenic selective arteriography is suggested&#44; but in the absence of active bleeding&#44; a decision is made to implement conservative therapy of the abdominal lesions&#46; The gallbladder lesion is managed through the gallbladder catheter that is kept during the whole hospital stay&#46; Also&#44; the surgery of the mandibular fracture is ruled out due to the lack of lateral deviation&#59; pain&#59; or opening&#47;closing alterations&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The patient was then transferred to the ICU for monitoring and fluid therapy&#46; Left endothoracic drainage was placed at a volume of 500 cc of hematic fluid for 24<span class="elsevierStyleHsp" style=""></span>h to be removed after 72<span class="elsevierStyleHsp" style=""></span>h and once the resolution was confirmed radiologically&#46; The patient was extubated at day 4&#44; and at day 5 both the surgical internal fixation of the humeral fracture&#44; and the escharotomy of the right ankle lesion were conducted&#44; resulting in a cutaneous defect of approximately 10<span class="elsevierStyleHsp" style=""></span>cm with exposure of the superficial peroneal nerve&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">At day 8&#44; one control CT scan is conducted that confirms the good progression of the aortic&#44; hepatic&#44; and renal lesions &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>C&#41;&#44; and the disappearance of the splenic and gallbladder lesions&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The patient was then taken to his room and discharged from the hospital 10 days later&#46; He required one graft at the back side of his right foot&#8211;procedure that was conducted outpatiently&#44; followed by one kinesiotherapy rehabilitation program&#44; and infiltration of the posterior tibial nerve&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">At present&#44; 30 months after being discharged from the hospital&#44; the patient shows no significant sequelae&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">In our setting&#44; we use different anatomical scoring systems&#44; among them the Injury Severity Score &#40;ISS&#41;&#44; or the Anatomic Profile &#40;AP&#41; that&#44; in our patient&#44; scored 45 and 15&#46;85 points&#44; respectively&#46; In order to calculate these scoring systems&#44; one <span class="elsevierStyleItalic">total-body CT scan</span> is required&#44;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">2</span></a> although recent publications show that the systematic use of such systems does not reduce mortality compared to the use of conventional imaging modalities&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">3</span></a> However&#44; the identification of possible subgroups that could benefit from the use of the aforementioned scoring systems is still pending&#46; We believe that in the case of a severe hemodynamically stable multi-trauma with unfavorable kinematics of trauma such as the case of a motorcycle crash at a speed of more than 32<span class="elsevierStyleHsp" style=""></span>km&#47;h with driver ejected&#44;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">4&#44;5</span></a> conducting one <span class="elsevierStyleItalic">total-body CT scan</span> would certainly benefit and guide the therapeutic plan&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">6</span></a> Upon hospital arrival&#44; both the examination of the patient and his chest X-rays were normal&#44; so had the <span class="elsevierStyleItalic">total-body CT scan</span> not been conducted&#44; the aortic lesion would have never been found&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The finding of minimum aortic lesions on CT scans can make us opt for medical management&#46; In more advanced lesions in patients selected with no risk of imminent free aortic rupture&#44; the endovascular therapy is feasible&#44;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">7</span></a> whose optimal time will depend on concomitant lesions and the resources available at the medical center&#46; In the case of pseudoaneurysmatic lesions like our patient&#39;s lesion with damage to less than 50 per cent of the aortic circumference&#44; an early repair may not be necessary in an attempt to improve the patient&#39;s condition and plan endovascular control with higher chances of success&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">8</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">ICU admissions are essential if we want to optimize the patient&#39;s hemodynamic situation&#59; medical management during and after the procedure&#59; and&#44; also&#44; if we want to monitor serious concomitant lesions&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a> The prognosis has improved in these selected cases&#44; especially in younger patients&#44; being the radiological confirmation useful for their resolution&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">In sum&#44; although today there is still controversy on which multi-trauma patients should be eligible for one <span class="elsevierStyleItalic">total-body CT scan</span>&#44; we believe that when in the presence of one multi-trauma hemodynamically stable patient with unfavorable kinematics of trauma&#44; conducting one <span class="elsevierStyleItalic">total-body CT scan</span> is advisable&#44; because it can avoid misdiagnoses of important lesions&#44; and is essential to plan minimally invasive management&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Authors</span><p id="par0085" class="elsevierStylePara elsevierViewall">Ms&#46; Sandra Dios&#44; and Ms&#46; Virginia Dur&#225;n conducted the reference search and shaped this manuscript&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Mr&#46; Felipe Pareja&#44; and Ms&#46; Virginia Dur&#225;n suggested the case and provided ideas on study design and concept&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Mr&#46; Felipe Pareja&#44; Ms&#46; Cristobalina Mart&#237;n&#44; Ms&#46; Mercedes Rubio&#44; and Mr&#46; Francisco Javier Padillo conducted the paper critical review and provided relevant know-how&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">All authors gave their approval to the final version of this paper&#46;</p></span></span>"
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Scientific Letter
Which multi-trauma patients benefit from performing a total-body CT?
¿Qué pacientes politraumatizados graves se benefician de la realización de un total-body CT?
S. Dios-Barbeito
Corresponding author
sandra.dios.barbeito@gmail.com

Corresponding author.
, V. Durán-Muñoz-Cruzado, C. Martín-García, M. Rubio-Manzanares-Dorado, F.J. Padillo-Ruiz, F. Pareja-Ciuró
Unidad de Cirugía General y Digestiva, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Severe traumas are an important cause of morbimortality&#44; being blunt traumas&#44; and traffic accidents the most common etiologies in our setting&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">1</span></a> Even though the non-surgical management of these patients is widely indexed in medical literature&#44; today there is still controversy on the indications of <span class="elsevierStyleItalic">total-body CT scans</span>&#44; and&#44; actually&#44; on some occasions&#44; it is determinant to establish surgical management&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">After obtaining the patient&#39;s informed consent&#44; we hereby present the case of one multi-trauma individual who was in serious condition after a motorcycle crash&#44; with non-surgical management of the patient&#39;s thoracoabdominal lesions and satisfactory progression&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Male&#59; 32 years old&#59; no significant clinical history&#59; the driver was wearing a helmet and suffered from high-energy trauma due to motorcycle crash with further ejection from the vehicle&#46; After initial assessment following the ATLS principles and confirmation of airway patency&#59; good ventilation&#59; hemodynamic stability&#59; and absence of severe CET&#44; the patient was transferred to a trauma reference center&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">We conducted the initial assessment upon arrival&#58; patient alert&#44; oriented&#44; and speaking in a coherent manner&#46; Good airway patency with cervical protection&#59; spontaneous respiration rate at 18<span class="elsevierStyleHsp" style=""></span>bpm&#59; symmetrical respiratory movement pattern&#59; absence of external signs of cervical and thoracic lesions&#59; and normal percussion&#44; and lung auscultation&#46; The patient remains hemodynamically normal at 80<span class="elsevierStyleHsp" style=""></span>bpm&#59; normothermic&#59; with adequate pulse&#59; capillary refill&#59; and cutaneous-mucosal coloration&#46; The possible bleeding focus may come from one right&#44; displaced&#44; humeral&#44; diaphisary fracture that is immobilized after the administration of anti-tetanus prophylaxis&#46; At abdominal level&#44; there is diffuse pain at palpation&#44; without any signs of peritonism&#44; or pain in the pelvis&#46; The patient shows macroscopic hematuria with spontaneous micturition&#44; but without any visible perineal alterations&#44; which is why we did not proceed with the catheterization of the gallbladder at that time&#46; The X-rays from the chest &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41;&#44; and the pelvis look normal&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The neurological assessment confirmed the presence of symmetrical reactive pupils&#59; a score of 15 in the Glasgow Coma Scale&#59; and no signs of lateralization or spine injury&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The secondary survey analyzed the skin surface&#44; and cleaned and sutured wounds in the lower lip region&#59; jaw&#59; right forearm&#59; and right ankle&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">In this context&#44; we conducted one <span class="elsevierStyleItalic">total-body CT scan</span> that found multiple lesions&#58; rupture of the descending thoracic aorta type IV with pseudoaneurysm&#59; periaortic hematoma&#59; small left hemithorax &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#59; posterior splenic lacerations grade II&#59; hepatic lacerations grade II in segment V with signs of active bleeding &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>A&#41;&#59; right posterior&#8211;superior renal laceration grade IV &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>B&#41;&#59; and gallbladder microperforation grade I&#46; There was no damage to the axial skeleton or the pelvic girdle&#44; but there were left and sternal nondisplaced mandibular fractures&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">The urgent percutaneous placement of one aortic endoprosthesis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C&#41; followed by hepatic&#44; renal&#44; and splenic selective arteriography is suggested&#44; but in the absence of active bleeding&#44; a decision is made to implement conservative therapy of the abdominal lesions&#46; The gallbladder lesion is managed through the gallbladder catheter that is kept during the whole hospital stay&#46; Also&#44; the surgery of the mandibular fracture is ruled out due to the lack of lateral deviation&#59; pain&#59; or opening&#47;closing alterations&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The patient was then transferred to the ICU for monitoring and fluid therapy&#46; Left endothoracic drainage was placed at a volume of 500 cc of hematic fluid for 24<span class="elsevierStyleHsp" style=""></span>h to be removed after 72<span class="elsevierStyleHsp" style=""></span>h and once the resolution was confirmed radiologically&#46; The patient was extubated at day 4&#44; and at day 5 both the surgical internal fixation of the humeral fracture&#44; and the escharotomy of the right ankle lesion were conducted&#44; resulting in a cutaneous defect of approximately 10<span class="elsevierStyleHsp" style=""></span>cm with exposure of the superficial peroneal nerve&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">At day 8&#44; one control CT scan is conducted that confirms the good progression of the aortic&#44; hepatic&#44; and renal lesions &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>C&#41;&#44; and the disappearance of the splenic and gallbladder lesions&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The patient was then taken to his room and discharged from the hospital 10 days later&#46; He required one graft at the back side of his right foot&#8211;procedure that was conducted outpatiently&#44; followed by one kinesiotherapy rehabilitation program&#44; and infiltration of the posterior tibial nerve&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">At present&#44; 30 months after being discharged from the hospital&#44; the patient shows no significant sequelae&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">In our setting&#44; we use different anatomical scoring systems&#44; among them the Injury Severity Score &#40;ISS&#41;&#44; or the Anatomic Profile &#40;AP&#41; that&#44; in our patient&#44; scored 45 and 15&#46;85 points&#44; respectively&#46; In order to calculate these scoring systems&#44; one <span class="elsevierStyleItalic">total-body CT scan</span> is required&#44;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">2</span></a> although recent publications show that the systematic use of such systems does not reduce mortality compared to the use of conventional imaging modalities&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">3</span></a> However&#44; the identification of possible subgroups that could benefit from the use of the aforementioned scoring systems is still pending&#46; We believe that in the case of a severe hemodynamically stable multi-trauma with unfavorable kinematics of trauma such as the case of a motorcycle crash at a speed of more than 32<span class="elsevierStyleHsp" style=""></span>km&#47;h with driver ejected&#44;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">4&#44;5</span></a> conducting one <span class="elsevierStyleItalic">total-body CT scan</span> would certainly benefit and guide the therapeutic plan&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">6</span></a> Upon hospital arrival&#44; both the examination of the patient and his chest X-rays were normal&#44; so had the <span class="elsevierStyleItalic">total-body CT scan</span> not been conducted&#44; the aortic lesion would have never been found&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The finding of minimum aortic lesions on CT scans can make us opt for medical management&#46; In more advanced lesions in patients selected with no risk of imminent free aortic rupture&#44; the endovascular therapy is feasible&#44;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">7</span></a> whose optimal time will depend on concomitant lesions and the resources available at the medical center&#46; In the case of pseudoaneurysmatic lesions like our patient&#39;s lesion with damage to less than 50 per cent of the aortic circumference&#44; an early repair may not be necessary in an attempt to improve the patient&#39;s condition and plan endovascular control with higher chances of success&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">8</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">ICU admissions are essential if we want to optimize the patient&#39;s hemodynamic situation&#59; medical management during and after the procedure&#59; and&#44; also&#44; if we want to monitor serious concomitant lesions&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a> The prognosis has improved in these selected cases&#44; especially in younger patients&#44; being the radiological confirmation useful for their resolution&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">In sum&#44; although today there is still controversy on which multi-trauma patients should be eligible for one <span class="elsevierStyleItalic">total-body CT scan</span>&#44; we believe that when in the presence of one multi-trauma hemodynamically stable patient with unfavorable kinematics of trauma&#44; conducting one <span class="elsevierStyleItalic">total-body CT scan</span> is advisable&#44; because it can avoid misdiagnoses of important lesions&#44; and is essential to plan minimally invasive management&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Authors</span><p id="par0085" class="elsevierStylePara elsevierViewall">Ms&#46; Sandra Dios&#44; and Ms&#46; Virginia Dur&#225;n conducted the reference search and shaped this manuscript&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Mr&#46; Felipe Pareja&#44; and Ms&#46; Virginia Dur&#225;n suggested the case and provided ideas on study design and concept&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Mr&#46; Felipe Pareja&#44; Ms&#46; Cristobalina Mart&#237;n&#44; Ms&#46; Mercedes Rubio&#44; and Mr&#46; Francisco Javier Padillo conducted the paper critical review and provided relevant know-how&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">All authors gave their approval to the final version of this paper&#46;</p></span></span>"
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                      "titulo" => "Factores pron&#243;sticos relacionados con la mortalidad del paciente con trauma grave&#58; desde la atenci&#243;n prehospitalaria hasta la Unidad de Cuidados Intensivos"
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                        0 => array:2 [
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                            3 => "M&#46; S&#225;nchez-Barba"
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                    0 => array:2 [
                      "titulo" => "Comparison of trauma scores for predicting mortality and morbidity on trauma patients"
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                        "tituloSerie" => "Ulus Travma Acil Cerrahi Derg"
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                        "paginaFinal" => "264"
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                      "titulo" => "When and how should we manage thoracic aortic injuries in the modern era&#63;"
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                        "tituloSerie" => "Interact Cardiovasc Thorac Surg"
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                    0 => array:2 [
                      "titulo" => "Nonoperative management of traumatic aortic pseudoaneurysms"
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                        "tituloSerie" => "Ann Vasc Surg"
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