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Penetrating chest injury

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https://www.readbyqxmd.com/read/29143074/-additional-emergency-medical-measures-in-trauma-associated-cardiac-arrest
#1
B Ondruschka, C Baier, J Dreßler, A Höch, M Bernhard, C Kleber, C Buschmann
INTRODUCTION: More than half of all traumatic deaths happen in prehospital settings. Until now, there have been no long-term studies examining the actual additive treatment during trauma-associated cardiopulmonary resuscitation (tCPR), including pleural decompression, pericardiocentesis, tourniquets and external stabilization of the pelvis. The present cohort study evaluated forensic autopsy reports of trauma deaths occurring at the scene with respect to additive actions in preclinical tCPR as well as the potentially preventable nature of the individual death cases...
November 15, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29124035/successful-tractotomy-technique-for-a-penetrating-lung-injury-in-a-patient-with-one-lung
#2
Dong Hoon Kang, Hyun Oh Park, Sung Ho Moon, In Seok Jang, Jung Hoon Byun, Sung Hwan Kim
We report the case of a patient with penetrating chest trauma (right chest) who had undergone a left pneumonectomy due to pulmonary tuberculosis 24 years ago. We performed an emergent thoracotomy, finding an opening of the penetrating wound in a lower-lobe basal segment of the right lung. A stapled tractotomy was performed along the tract. Bleeding control and air-leakage control was done easily and rapidly. The patient was discharged without any complications on the seventh day of admission. Tractotomy can be a good option for treating penetrating lung injuries in patients with limited lung function who need emergent surgery...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29076689/management-of-penetrating-injury-to-thoracic-inlet-and-lower-neck-with-retained-foreign-body-using-video-assisted-thoracoscopic-surgery
#3
Muhammad Adeel Samad, Hamza Abdur Rahim Khan, Faiza Urooj, Usman Ali Hyder, Fazal Wahab Khan, Saulat Hasnain Fatimi, Jamal Kabeer Khan
Penetrating neck and chest injuries are a common form of occupational injuries. We hereby report a unique case in which a metallic rod had penetrated the left chest and neck of a plastic factory worker. The patient was vitally stable when he presented to Emergency Room. Chest X-ray was performed and the patient was rushed to the operating room. VATS (video assisted thoracoscopic surgery) and neck dissection was done for retrieval of the metallic rod. On table, endoscopy was also done to rule out injury to oesophagus...
July 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29063459/tension-pneumopericardium-following-suicidal-stab-wounds-to-the-chest
#4
Jakob Heimer, Stephan A Bolliger, Michael J Thali, Wolf Schweitzer
Pneumopericardium (PPC) and Tension Pneumopericardium (TPPC) refer to collections of gas in the pericardial cavity, the latter resulting in air tamponade and cardiac compromise. Following penetrating chest injuries, PPC and TPPC appear to be uncommon findings associated with a high mortality and correlated with other thoracic trauma. Diagnosis of PPC and TPPC is difficult relying on conventional autopsy alone, while postmortem computed tomography (PMCT) shows a high sensitivity for the detection of internal gas collections...
October 23, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28968251/hypothermia-does-not-influence-liver-damage-and-function-in-a-porcine-polytrauma-model
#5
D Eschbach, K Horst, M Sassen, J Andruszkow, J Mohr, F Debus, N Vogt, T Steinfeldt, F Hildebrand, K Schöller, E Uhl, H Wulf, S Ruchholtz, H Pape, M Frink
BACKGROUND: Previous studies revealed evidence that induced hypothermia attenuates ischemic organ injuries after severe trauma. In the present study, the effect of hypothermia on liver damage was investigated in a porcine long term model of multi-system injury, consisting of blunt chest trauma, penetrating abdominal trauma, musculoskeletal injury, and hemorrhagic shockMETHODS: In 30 pigs, a standardized polytrauma including blunt chest trauma, penetrating abdominal trauma, musculoskeletal injury, and hemorrhagic shock of 45% of total blood volume was induced...
September 15, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/28958357/thoracic-trauma
#6
REVIEW
Bradley M Dennis, Seth A Bellister, Oscar D Guillamondegui
Management of chest trauma is integral to patient outcomes owing to the vital structures held within the thoracic cavity. Understanding traumatic chest injuries and appropriate management plays a pivotal role in the overall well-being of both blunt and penetrating trauma patients. Whether the injury includes rib fractures, associated pulmonary injuries, or tracheobronchial tree injuries, every facet of management may impact the short- and long-term outcomes, including mortality. This article elucidates the workup and management of the thoracic cage, pulmonary and tracheobronchial injuries...
October 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28930941/thoracic-irrigation-prevents-retained-hemothorax-a-prospective-propensity-scored-analysis
#7
Nathan W Kugler, Thomas W Carver, David Milia, Jasmeet S Paul
BACKGROUND: Thoracic trauma resulting in hemothorax (HTx) is typically managed with thoracostomy tube (TT) placement; however, up to 20% of patients develop retained HTx which may necessitate further intervention for definitive management. While optimal management of retained HTx has been extensively researched, little is known about prevention of this complication. We hypothesized thoracic irrigation at the time of TT placement would significantly decrease the rate of retained HTx necessitating secondary intervention...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28912997/laparoscopic-repair-of-diaphragmatic-rupture-a-case-report-with-radiological-and-surgical-correlation
#8
Patrick Nguyen, Bonnie Davis, Daniel D Tran
The leading cause of diaphragmatic rupture is penetrating abdominal trauma, including gunshot- and stab-related wounds; however, diaphragmatic rupture can also result from blunt trauma to the abdomen. The diagnosis can be difficult to make as the physical examination may be unremarkable, and imaging, that is, a conventional chest X-ray and/or CT imaging, may initially fail to reveal the injury. Failure to recognize diaphragmatic rupture can result in a delayed presentation, sometimes years later, with a potential catastrophic outcome...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28910475/chest-seal-placement-for-penetrating-chest-wounds-by-prehospital-ground-forces-in-afghanistan
#9
Steven G Schauer, Michael D April, Jason F Naylor, Erica M Simon, Andrew D Fisher, Cord W Cunningham, Daniel M Morissette, Jessie Renee D Fernandez, Kathy L Ryan
BACKGROUND: Thoracic trauma represents 5% of all battlefield injuries. Communicating pneumothoraces resulting in tension physiology remain an important etiology of prehospital mortality. In addressing penetrating chest trauma, current Tactical Combat Casualty Care (TCCC) guidelines advocate the immediate placement of a vented chest seal device. Although the Committee on TCCC (CoTCCC) has approved numerous chest seal devices for battlefield use, few data exist regarding their use in a combat zone setting...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28910472/a-descriptive-analysis-of-occupational-fatalities-due-to-felonious-assault-among-u-s-law-enforcement-officers-during-tactical-incidents-1996-2014
#10
Moriah S Thompson, Tyler M Hartman, Matthew D Sztajnkrycer
INTRODUCTION: Little is known about occupational fatalities among tactical officers. A greater understanding of such injuries is needed to improve officer safety. The purpose of this study was to provide a descriptive analysis of line-of-duty deaths secondary to felonious assault during tactical incidents. METHODS: Retrospective analysis was performed of open-source de-identified Federal Bureau of Investigation Uniform Crime Reporting Law Enforcement Officers Killed and Assaulted (LEOKA) data inclusive of the years 1996-2014...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28894371/radiologic-findings-of-thoracic-trauma
#11
Cihan Akgul Ozmen, Serdar Onat, Delal Aycicek
INTRODUCTION: Chest trauma may be blunt or penetrating and the chest is the third most common trauma region. It is a significant cause of mortality. Multidetector computed tomography (MDCT) has been an increasingly used method to evaluate chest trauma because of its high success in detecting tissue and organ injuries. Herein, we aimed to present MDCT findings in patients with blunt and penetrating chest trauma admitted to our department. METHODS: A total of 240 patients admitted to the emergency department of our hospital between April 2012 and July 2013 with a diagnosis of chest trauma who underwent MDCT evaluations were included...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28878879/if-i-had-a-hammer
#12
M Tarazi, N Mayooran, J Hinchion
We present the case of a 64-year-old man who was referred to our service after sustaining a self-inflicted nail-gun injury to his chest. He received three nails penetrated into his chest. Computer tomography revealed no massive haemorrhage or damage to major vessels. He underwent an emergency sternotomy, two nails caused pericardial perforation and myocardial injury were noted easily and removed easily via sternotomy. Myocardial injury showed a trajectory near the junction of the left anterior descending artery and the diagonal artery with no significant bleeding appreciated...
August 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28876671/screening-for-an-occult-penetrating-cardiac-injury-using-transoesophageal-echcardiography-toe-a-prospective-study
#13
A Nicol, K Steur, R Bent, R Myburgh, G Sudwarts, F Roodt, S Edu, P Navsaria
BACKGROUND: 30% of patients with a cardiac injury will present with a penetrating chest wound and be haemodynamically stable, the so-called "occult cardiac injury". Current international practice is to screen for occult cardiac injuries using ultrasound (US) of the pericardial sac. If the US confirms the presence of fluid, then the patient undergoes a subxiphoid pericardial window (SPW) under general anaesthetic. In our experience, US Results in a large number of false positives and unnecessary operations...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876667/evaluation-of-thoracoscopy-in-the-diagnosis-of-diaphragmatic-injuries-in-penetrating-thoracoabdominal-trauma-without-lung-deflation-at-dr-george-mukhari-academic-hospital
#14
L Nsakala
BACKGROUND: With a mortality estimated at 25% when missed, diaphragmatic injuries due to penetrating thoracoabdominal trauma present a diagnostic challenge for both the radiologist and the surgeon. In the current literature, chest x-ray has a sensitivity of 27-60% for left-sided injuries and only 17% for right-sided injuries while, CT scan has a sensitivity of 14-61% and a specificity of 76-99%. Thoracoscopy using a single lung ventilation is one of the modalities of choice for the diagnosis of these injuries with a specificity of 100% and a sensitivity of 87...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876661/the-use-of-laparoscopy-in-managing-penetrating-thoracoabdominal-injuries-in-africa-83-cases-reviewed
#15
M Z Koto, F Mosai, O Y Matsevych
BACKGROUND: The use of laparoscopy in managing haemodynamically stable patients with penetrating thoracoabdominal injuries in developed countries is wildly practised, but in Africa the use of laparoscopy is still in its infancy stage. METHOD: A retrospective analysis of prospectively collected data of patients presenting with penetrating thoracoabdominal injuries was done. All patients offered laparoscopic exploration and repair from January 2012 to December 2015 at Dr George Mukhari Academic Hospital were analysed...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28818179/multiple-trauma-and-emergency-room-management
#16
Michael Frink, Philipp Lechler, Florian Debus, Steffen Ruchholtz
BACKGROUND: The care of severely injured patients remains a challenge. Their initial treatment in the emergency room is the essential link between first aid in the field and definitive in-hospital treatment. METHODS: We present important elements of the initial in-hospital care of severely injured patients on the basis of pertinent publications retrieved by a selective search in PubMed and the current German S3 guideline on the care of severely and multiply traumatized patients, which was last updated in 2016...
July 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28762458/removal-of-cardiothoracic-war-related-shrapnel-using-video-assisted-thoracoscopic-surgery
#17
Mohammed Khalifa, Fikri M Abu-Zidan, Navidul Khan, Edward Black
This is the first report in the literature to describe removing war-related cardiothoracic shrapnel using video-assisted thoracoscopic surgery (VATS). War blast caused penetrating thoracic and extremity injuries in 30-year-old man. He was referred to our hospital after stabilization. Magnetic resonance imaging was required to evaluate brachial plexus injury. Large, penetrating shrapnel fragment in the right posterior chest wall, retained shrapnel in apex of the right lung, and another fragment in the pericardium were removed using VATS in staged approach...
July 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28759541/traumatic-ventricular-septal-defect-after-stab-wound-to-the-chest-missed-by-transthoracic-echocardiography-a-case-report
#18
Abimbola O Faloye, Raphael Y Gershon
Traumatic ventral septal defect may be sustained after either blunt force or penetrating trauma to the chest. Severity ranges from asymptomatic to acute decompensated heart failure. Our patient suffered a stab wound to the chest and was initially taken to the operating room for repair of a lacerated right ventricle. Subsequent postoperative hemodynamic deterioration prompted a bedside transthoracic echocardiogram, which failed to identify causal factors. A transesophageal echocardiogram performed immediately after ventral septal defect was demonstrated...
August 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28752438/-blunt-and-penetrating-thoracic-trauma
#19
B Mühling
In most cases blunt chest trauma leads to fractures of the bony thorax, i. e. ribs. In the case of accompanying hemothorax or pneumothorax initial management consists of chest tube drainage by mini-thoracotomy. Subsequently patients with blunt chest trauma have to be transferred to the intensive care unit as these patients are at risk of pulmonary insufficiency or persistent blood loss via the chest tube. Injury to the great vessels or heart requires trauma care in specialized centers. Penetrating trauma is always surgically treated and the foreign body is removed in the operating room (OR)...
September 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28736096/pneumoperitoneum-by-inguinal-laceration-after-traffic-accident
#20
Daesung Lim, Soo Hoon Lee, Sang Bong Lee, TaeJin Park
BACKGROUND: The leading cause of surgical pneumoperitoneum is hollow viscus perforation, which accounts for approximately 90% of cases. A nonsurgical etiology may account for up to about 10% of the causes of pneumoperitoneum. However, a pneumoperitoneum often poses significant management dilemmas for surgeons, especially when signs of peritonitis are absent or when the cause is unknown prior to laparotomy. We present the first case of pneumoperitoneum due to inguinal laceration without viscus perforation after a traffic accident...
July 20, 2017: Journal of Emergency Medicine
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