Brandon Diaz | University of Miami (original) (raw)

Papers by Brandon Diaz

Cureus, 2021

Brummund et al. This is an open access article distributed under the terms of the Creative Common... more Brummund et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

International Journal of Surgery Case Reports, Feb 1, 2021

International Journal of Surgery Case Reports, 2021

INTRODUCTION: Blunt thoracic aortic injuries (BTAIs) are an uncommon traumatic injury that if not... more INTRODUCTION: Blunt thoracic aortic injuries (BTAIs) are an uncommon traumatic injury that if not treated promptly, can result in death. We present the case of a BTAI with aberrant aortic anatomy. PRESENTATION OF CASE: A 60-year-old female was involved in a motor vehicle crash where she suffered significant polytrauma including a BTAI. She was also found to have an aberrant right subclavian artery originating from the aortic arch. Thoracic Endovascular Aortic Repair (TEVAR) with a right common carotid artery to right subclavian artery bypass was accomplished. She required three more vascular surgical interventions, two for persistent type II endoleak and the third for left upper extremity acute limb ischemia. She had a 2-month hospital course for her devastating injuries and was eventually discharged home. A follow-up CT angiogram showed a stable thoracic aortic arch stent. DISCUSSION: BTAIs are uncommon in the trauma population. In our patient who had an aberrant right subclavian artery, further procedures were required in the form of a right common carotid artery to right subclavian artery bypass and embolizations to resolve endoleaks. CONCLUSION: Blunt thoracic aortic injuries are life threatening and require urgent intervention. TEVAR is associated with better outcomes. An aberrant right subclavian artery originating from the aortic arch, distal to the left subclavian artery is an anatomic variant that adds significant complexity to TEVAR. TEVAR is still an option for repair of blunt thoracic aortic injuries despite anatomic variations as open repair still carries an increased risk of morbidity and mortality.

International Journal of Surgery Case Reports, 2019

Journal of Emergencies, Trauma, and Shock, 2019

Introduction: Traumatic intracranial hemorrhages (ICHs) are high priority injuries. Traumatic bra... more Introduction: Traumatic intracranial hemorrhages (ICHs) are high priority injuries. Traumatic brain bleeds can be categorized as traumatic subarachnoid hemorrhage (SAH) versus non-SAH-ICH. Non-SAH-ICH includes subdural, epidural, and intraventricular hematomas and brain contusions. We hypothesize that awake patients with SAH will have lower mortality and needless interventions than awake patients with non-SAH-ICHs. Study Design and Methods: A review of data collected from our Level I trauma center was conducted. Awake was defined as an initial Glasgow coma score (GCS) 13–15. Patients were divided into two cohorts: awake SAH and awake non-SAH-ICH. Chi-square and t-test analyses were used with statistical significance defined as P < 0.05. Results: A total of 12,482 trauma patients were admitted during the study period, of which 225 had a SAH and GCS of 13–15 while 826 had a non-SAH-ICH with a GCS of 13–15. There was no significant difference in demographics between the two groups. Predicted survival between the two groups was similar (97.3 vs. 95.7%,P > 0.05). Mortality rates were, however, significantly lower in SAH patients compared to the non-SAH-ICH (4/225 [1.78%] vs. 22/826 [2.66%], P < 0.05). The need for neurosurgical intervention was significantly different comparing the SAH group versus non-SAH-ICH (2/225 [0.89%] vs. 100/826 [12.1%], P < 0.05). Conclusion: Despite similar predicted mortality rates, awake patients with a SAH are associated with a significantly lower risk of death and need for neurosurgical intervention when compared to other types of awake patients with a traumatic brain bleed.

International Journal of Surgery Case Reports, 2019

This is a case report of a rare adrenal tumor that manifested as acute coronary syndrome. • Adren... more This is a case report of a rare adrenal tumor that manifested as acute coronary syndrome. • Adrenalectomy for pheochromocytoma presents a risk for intraoperative hemodynamic instability. Preoperative medical care is essential to reduce intraoperative complications. • This case exemplifies the importance of the various symptoms that are prevalent with excessive circulating adreno-receptor agents.

International Journal of Surgery Case Reports, 2018

INTRODUCTION: There is no clear standardized approach to complicated appendicitis associated with... more INTRODUCTION: There is no clear standardized approach to complicated appendicitis associated with abscess or phlegmon, with treatment varying from immediate appendectomy versus non-operative management with antibiotics and possible interval appendectomy. This case report reviews a presentation of complicated appendicitis failing non-operative therapy and reviews the literature on complicated appendicitis. PRESENTATION OF CASE: : A 19 year-old male presented with right lower quadrant pain, leukocytosis, and fever. He had been seen at an outside hospital, diagnosed with complicated appendicitis, treated non-operatively, and discharged on antibiotics. CT confirmed persistent complicated appendicitis; he was again treated non-operatively with resolution of symptoms. He was discharged but returned with recurrent pain/leukocytosis. The patient was determined to have failed non-operative management, underwent laparoscopic appendectomy. Post-operatively he improved was doing well in follow up. DISCUSSION: Historically, the therapy for acute appendicitis has been surgical. However, immediate surgical management of complicated appendicitis is often associated with increased complications. Nonoperative management with antibiotics and interval appendectomy in cases of complicated appendicitis is an option. Literature shows that non-operative management of complicated appendicitis is not entirely innocuous. Non-operative management carries a significant failure rate. Patients that undergo immediate appendectomy may have a better health-related quality of life. Non-operative management of complicated appendicitis may lead to worse outcomes and higher healthcare costs. CONCLUSION: Non-operative management of complicated appendicitis has significant failure rates, increased healthcare costs, and perhaps increased morbidity when compared to immediate surgical management. Immediate surgical management of complicated appendicitis remains the gold standard and should be used in most patients.