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Penetrating chest injury

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https://www.readbyqxmd.com/read/28423132/repair-of-penetrating-pericardial-and-diaphragmatic-injury-with-cormatrix%C3%A2-patch-in-a-case-of-suicide-attempt
#1
Federica Jiritano, Carlo Garrasi, Lucia Cristodoro, Egidio Bevacqua, Pasquale Mastroroberto
The authors report the case of a suicide attempt. A 59-year-old man with self-inflicted penetrating chest trauma underwent emergency cardiothoracic surgery. Pre-operative computed tomography scan showed critical proximity between the blade and the right ventricle. Intraoperative findings showed a pericardial laceration and a huge diaphragmatic lesion with heart and abdominal organs integrity. The diaphragm muscle was repaired with a CorMatrix® patch, an acceptable alternative to the traditional synthetic mesh avoiding infection and repeated herniation...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28400940/early-diagnosis-of-penetrating-cardiac-and-pleural-injury-by-extended-focused-assessment-with-sonography-for-trauma
#2
K P Singaravelu, Rama Prakasha Saya, Vinay R Pandit
In India, stab injury is not uncommon, but identifying potential life threatening conditions in the emergency room (ER) and initiating prompt treatment are challenging. This is a case report of a young patient who presented to the ER with assault injury to the chest and shock; timely extended focused assessment with sonography for trauma helped to fast-track the patient to the operating room. A brief review of diagnosis and management of penetrating cardiac injury is presented herewith.
October 2016: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/28369306/surgical-management-of-penetrating-thoracic-injuries-during-the-paris-attacks-on-13-november-2015
#3
Guillaume Boddaert, Pierre Mordant, Françoise Le Pimpec-Barthes, Emmanuel Martinod, Sonia Aguir, Pascal Leprince, Mathieu Raux, Jean-Paul Couëtil, Antonio Fiore, Thomas Lescot, Brice Malgras, François Pons, Yves Castier
OBJECTIVES: The Paris terrorist attacks on 13 November 2015 caused 482 casualties, including 130 deaths and 352 wounded. Facing these multisite terrorist attacks, Parisian public and military hospitals simultaneously managed numerous patients with penetrating thoracic injuries. The aim of this study was to analyse this cohort, the injury patterns, and assess the results of this mobilization. METHODS: The clinical records of all patients admitted to Parisian public and military hospitals with a penetrating thoracic injury related to the Paris 13 November terrorist attacks were reviewed...
March 27, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28318439/focused-assessment-with-sonography-in-trauma-fast-in-2017-what-radiologists-can-learn
#4
John R Richards, John P McGahan
Focused assessment with sonography in trauma (FAST) has been extensively utilized and studied in blunt and penetrating trauma for the past 3 decades. Prior to FAST, invasive procedures such as diagnostic peritoneal lavage and exploratory laparotomy were commonly utilized to diagnose intraabdominal injury. Today the FAST examination has evolved into a more comprehensive study of the abdomen, heart, chest, and inferior vena cava, and many variations in technique, protocols, and interpretation exist. Trauma management strategies such as laparotomy, laparoscopy, endoscopy, computed tomographic angiography, angiographic intervention, serial imaging, and clinical observation have also changed over the years...
April 2017: Radiology
https://www.readbyqxmd.com/read/28255150/computed-tomography-of-the-thorax-with-3d-reconstruction-in-penetrating-chest-injury
#5
A Michael, Z O Yahya, I Mdrazali, H Hanif
Penetrating chest wounds is less common but more deadly then blunt trauma. Majority of penetrating chest trauma can be managed conservatively with observation and simple thoracotomy. This case report highlights a bizarre occupational hazard causing a penetrating chest injury and the option of non-invasive management with the aid of computed tomography with 3D reconstruction.
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28203439/evolutional-trends-in-the-management-of-tracheal-and-bronchial-injuries
#6
REVIEW
Brendan Patrick Madden
Tracheal and Bronchial injuries are potentially life threatening complications which require urgent diagnosis and therapeutic intervention. They typically occur in association with blunt and penetrating chest trauma although they are increasingly being encountered in patients following endobronchial intervention and percutaneous tracheostomy insertion. Their precise incidence is unknown. Presenting features include dyspnoea, stridor, respiratory and haemodynamic compromise, haemoptysis, surgical emphysema, pneumothorax and persistent significant airleak...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28191375/self-inflicted-cardiac-injury-with-nail-gun-without-hemodynamic-compromise-a-case-report
#7
Simon Ho, Bo Liu, Nicholas Feranec
Pneumatically powered nail guns have been used in construction since 1959. Penetrating injuries to the heart with nail guns have a wide range of presentations from asymptomatic to cardiac tamponade and exsanguination. Mortality related to cardiac nail gun injuries is similar to knife injuries, estimated at 25%. Surgical exploration is the treatment of choice. We describe a case of self-inflicted nail gun injury to the chest without hemodynamic compromise in a 51-year-old man. Computed tomography (CT) imaging confirmed nail penetrating the right ventricle, with the tip adjacent to but not violating the abdominal aorta...
January 10, 2017: Curēus
https://www.readbyqxmd.com/read/28190583/fibrinogen-is-an-independent-predictor-of-mortality-in-major-trauma-patients-a-five-year-statewide-cohort-study
#8
Zoe K McQuilten, Erica M Wood, Michael Bailey, Peter A Cameron, David J Cooper
INTRODUCTION: Fibrinogen may be reduced following traumatic injury due to loss from haemorrhage, increased consumption and reduced synthesis. In the absence of clinical trials, guidelines for fibrinogen replacement are based on expert opinion and vary internationally. We aimed to determine prevalence and predictors of low fibrinogen on admission in major trauma patients and investigate association of fibrinogen levels with patient outcomes. PATIENTS AND METHODS: Data on all major trauma patients (January 2007-July 2011) identified through a prospective statewide trauma registry in Victoria, Australia were linked with laboratory and transfusion data...
November 21, 2016: Injury
https://www.readbyqxmd.com/read/28186860/traumatic-rib-injury-patterns-imaging-pitfalls-complications-and-treatment
#9
Brett S Talbot, Christopher P Gange, Apeksha Chaturvedi, Nina Klionsky, Susan K Hobbs, Abhishek Chaturvedi
The ribs are frequently affected by blunt or penetrating injury to the thorax. In the emergency department setting, it is vital for the interpreting radiologist to not only identify the presence of rib injuries but also alert the clinician about organ-specific injury, specific traumatic patterns, and acute rib trauma complications that require emergent attention. Rib injuries can be separated into specific morphologic fracture patterns that include stress, buckle, nondisplaced, displaced, segmental, and pathologic fractures...
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28185476/penetrating-chest-injuries-caused-by-swordfish-sword-used-as-a-weapon
#10
Assane Ndiaye, Magaye Gaye, Papa Salmane Ba, Souleymane Diatta, Momar Sokhna Diop, Mouhamadou Ndiaye
We report 5 cases of penetrating chest wounds caused by weapons made from swordfish swords, involving breakage of the sword that later appeared as a thoracic foreign body. The patients had been assaulted 2 days to 17 years earlier. Three of them had a chronic infected wound, one had a penetrating thoracic wound with hemopneumothorax, and one had a foreign body. Computed tomography showed a foreign body in the lung in 4 cases, with aortic penetration in one. The foreign body was removed via thoracotomy in all 4 patients, with aorta repair in one who presented later with a pseudoaneurysm...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28164016/isolated-rupture-of-bicuspid-aortic-valve-following-blunt-chest-trauma-a-case-report-and-systematic-review-of-literature
#11
Hemindermeet Singh, Sajid Ali, Faraz Khan Luni, Fayyaz Hashmi, Mohammed Taleb
Blunt trauma to chest cause injury to various cardiac structures. Isolated rupture of aortic valve without aortic dissection is rare complication of blunt chest trauma and can be caused by a tear or avulsion of the valve. We report a case of a 35-year-old male who presented with severe aortic insufficiency due to rupture of a non-infected congenital bicuspid aortic valve following non-penetrating chest trauma. The diagnosis was suggested by echocardiography and was confirmed by intra-operative and histological findings...
February 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27994332/thoracotomy-for-traumatic-diaphragmatic-hernia
#12
Zhang Fangbiao, Zheng Chunhui, Zhao Chun, Shi Hongcan, Zhang Xiangyan, Tu Shaosong
The aim of this retrospective study is to review our experience in the diagnosis and role of thoracotomy for traumatic diaphragmatic hernia (TDH). Between January 2008 and June 2014, 23 patients from Yangzhou Medical College (Yangzhou China) and Lishui Center Hospital (Lishui China), who underwent thoracotomy for TDH, were analyzed. The clinical features, imaging findings, operative findings, and outcome of treatment in these patients are presented. There were 23 patients (18 males and 5 females) who underwent surgical procedures due to TDH...
October 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27982326/analysis-of-the-revised-trauma-score-rts-in-200-victims-of-different-trauma-mechanisms
#13
Bruno Durante Alvarez, Danilo Mardegam Razente, Daniel Augusto Mauad Lacerda, Nicole Silveira Lother, Luiz Carlos VON-Bahten, Carla Martinez Menini Stahlschmidt
Objective: to analyze the epidemiological profile and mortality associated with the Revised Trauma Score (RTS) in trauma victims treated at a university hospital. Methods: we conducted a descriptive, cross-sectional study of trauma protocols (prospectively collected) from December 2013 to February 2014, including trauma victims admitted in the emergency room of the Cajuru University Hospital. We set up three groups: (G1) penetrating trauma to the abdomen and chest, (G2) blunt trauma to the abdomen and chest, and (G3) traumatic brain injury...
September 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/27965930/a-case-of-severe-thoracoabdominal-impalement-by-a-steel-bar
#14
Ki Tae Kim, Pil Won Seo
A 53-year-old man arrived at the trauma center with a steel bar penetrating from the epigastrium to the right scapula. He was hypotensive and hypoxic, and immediate resuscitation and basic evaluation were performed. An emergency operation was performed due to an unstable hemodynamic state. Multiple injuries were confirmed in the right lower lobe, posterior chest wall, diaphragm, and liver lateral segment. Right lower lobectomy and liver lateral sectionectomy were performed following removal of the bar. The patient recovered without additional hemorrhage after the surgery, and was transferred to a rehabilitation institution with periodic follow-up...
December 2016: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27933327/traumatic-diaphragmatic-injuries-a-retrospective-review-of-the-12-year-experience-at-a-tertiary-trauma-centre
#15
Beng Leong Lim, Li Tserng Teo, Ming Terk Chiu, Marxengel L Asinas-Tan, Eillyne Seow
INTRODUCTION: Traumatic diaphragmatic injuries (TDIs) are clinically challenging. We aimed to review TDIs treated at a tertiary trauma centre over a 12-year period. METHODS: This was a single-centre retrospective review of adult patients with TDIs treated between 1 January 2003 and 31 December 2014. Primary outcomes were mortality rates and Injury Severity Scores (ISS) associated with each TDI subtype. Secondary outcomes included proportions of TDIs diagnosed radiologically, operatively or during autopsy...
December 9, 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/27871107/the-large-omnidirectional-child-lodc-atd-biofidelity-comparison-with-the-hybrid-iii-10-year-old
#16
Jason Stammen, Kevin Moorhouse, Brian Suntay, Michael Carlson, Yun-Seok Kang
When the Hybrid III 10-year old (HIII-10C) anthropomorphic test device (ATD) was adopted into Code of Federal Regulations (CFR) 49 Part 572 as the best available tool for evaluating large belt-positioning booster seats in Federal Motor Vehicle Safety Standard (FMVSS) No. 213, NHTSA stated that research activities would continue to improve the performance of the HIII-10C to address biofidelity concerns. A significant part of this effort has been NHTSA's in-house development of the Large Omnidirectional Child (LODC) ATD...
November 2016: Stapp Car Crash Journal
https://www.readbyqxmd.com/read/27866218/prevalence-of-negative-ct-scans-in-a-level-one-trauma-center
#17
C K Hansen, R J Strayer, B D Shy, S Kessler, S Givre, K H Shah
PURPOSE: The rise of computed tomography (CT) use in trauma has become the subject of concern given the harms of CT including radiation, cost, over diagnosis and identification of incidental lesions. We developed a novel metric, the Negative CT Score, (∑CT-) which quantifies how often CT imaging identifies important injuries. Our objective was to describe the pattern of CT utilization in trauma at an urban academic level one trauma center using this novel metric. METHODS: This was a retrospective study of intermediate level trauma patients who received CT imaging over a 1-year study period at an urban level one trauma center...
November 19, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27847077/a-close-call-an-impacted-knife-injury-to-the-thorax
#18
Tim Kaufeld, Christian Zeckey, Steffen Marquardt, Christian Krettek, Axel Haverich, Igor Tudorache
A 21-year-old woman with a history of psychiatric treatment was admitted to the emergency department with self-inflicted stab wounds to the neck, chest, and abdomen as the result of a suicide attempt. Inspection showed a seemingly superficial cut at the jugular fossa. The patient's mother stated that one long ceramic kitchen bread knife was totally embedded in the right thorax. Further diagnostic measures showed the missing kitchen bread knife penetrating the right chest, with the path of insertion starting 2 cm above the right clavicle and the blade in contact with the right hilum and ending next to the seventh thoracic vertebra...
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27821826/-penetrating-injury-of-the-lung-with-a-glass-splinter
#19
Masahiro Yamada, Masami Abiko, Hirohisa Katoh, Makoto Endoh
A 62-year-old man got drunk and dived into the windowpane. He received lacerations on his face and incised wound at his right chest, and was carried to our hospital. Computed tomography showed a glass splinter, about 14 cm of length, in the chest cavity. The patient underwent an emergency thoracotomy and it was found that the glass splinter penetrated through the upper lobe to the hilum. After removing the glass, simple closure by suturing the entrance and exit of the upper lobe was performed. The post operational course was uneventful...
November 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27768660/identifying-potential-utility-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-an-autopsy-study
#20
Bellal Joseph, Kareem Ibraheem, Ansab A Haider, Narong Kulvatunyou, Andrew Tang, Terence O'Keeffe, Zachary M Bauman, Donald J Green, Rifat Latifi, Peter Rhee
BACKGROUND: Resuscitative thoracotomy (RT) has been the standard therapy in patients with acute arrest due to hemorrhagic shock. However, with the development of resuscitative endovascular balloon occlusion of the aorta (REBOA), its role as a potential adjunct to a highly morbid intervention such as RT is being discussed. The aim of this study was to identify patients who most likely would have potentially benefited from REBOA use based on autopsy findings. METHODS: We performed a 4-year retrospective review of all RTs performed at our Level I trauma center...
November 2016: Journal of Trauma and Acute Care Surgery
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