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https://www.readbyqxmd.com/read/28449513/thoracoscopic-management-of-incarcerated-lung-herniation-after-blunt-chest-trauma-a-case-report-and-literature-review
#1
Ting-Yen Chiang, Ming-Fang Yin, Shun-Mao Yang, Ke-Cheng Chen
Traumatic lung herniation is a rare condition that is usually treated with thoracotomy and pericostal fixation of adjacent ribs with sutures. We described a traumatic lung herniation case successfully managed with hernia reduction and double-layered repair of the intrathoracic defect, completed via a total thoracoscopic approach.
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28449426/-a-case-of-intramural-hematoma-of-the-esophagus-mimicking-acute-coronary-syndrome
#2
Dae Gon Ryu, Cheol Woong Choi, Dae Hwan Kang, Hyung Wook Kim, Dong Il Jeong, Wan Chul Kim, Jae Gyu Shin, Tae Won Lim
Intramural hematoma of the esophagus is a rare condition that can be spontaneous or secondary to trauma, toxic ingestion, or intervention. If it is the spontaneous type, it usually presents initially with epigastric pain, hematemesis or dysphagia. We present a case of intramural hematoma of the esophagus mimicking acute coronary syndrome. A 63-year-old man presented with severe acute chest pain. He has four coronary stents that were inserted five years ago, from a different hospital, and is on dual antiplatelet agents...
April 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28446987/blunt-chest-trauma-is-there-a-place-for-rib-stabilization
#3
REVIEW
John D Mitchell
Rib fractures are a common and highly morbid finding in patients with blunt chest trauma. Over the past decade, a renewed interest in (and instrumentation for) rib fixation in this cohort has occurred. Stabilization of the chest wall in this setting, particularly when a flail segment is present, is associated with significant reductions in the rates of respiratory failure, pneumonia, ICU stay, and mortality. Thoracic surgeons should remain actively involved in this evolving area of our specialty to further optimize patient outcomes...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28446982/management-of-chest-trauma
#4
REVIEW
Corinna Ludwig, Aris Koryllos
Trauma is the leading cause of death worldwide. Approximately 2/3 of the patients have a chest trauma with varying severity from a simple rib fracture to penetrating injury of the heart or tracheobronchial disruption. Blunt chest trauma is most common with 90% incidence, of which less than 10% require surgical intervention of any kind. Mortality is second highest after head injury, which underlines the importance of initial management. Many of these deaths can be prevented by prompt diagnosis and treatment...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28445175/traumatic-ventral-septal-defect-after-stab-wound-to-the-chest-missed-by-transthoracic-echocardiogram-a-case-report
#5
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...
April 25, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28435496/-choosing-wisely-imaging-recommendations-initial-implementation-in-new-england-emergency-departments
#6
Ali S Raja, Arjun Venkatesh, Nathan Mick, Cristopher P Zabbo, Kohei Hasegawa, Janice A Espinola, Jane C Bittner, Carlos A Camargo
INTRODUCTION: In June 2016, the American College of Emergency Physicians (ACEP) Emergency Quality Network began its Reduce Avoidable Imaging Initiative, designed to "reduce testing and imaging with low risk patients through the implementation of Choosing Wisely recommendations." However, it is unknown whether New England emergency departments (ED) have already implemented evidence-based interventions to improve adherence to ACEP Choosing Wisely recommendations related to imaging after their initial release in 2013...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28431721/intra-aortic-missile-after-gunshot-wound-to-chest-an-interesting-case-of-traumatic-cardiac-injury
#7
Charles D Fraser, Lee Goeddel, Nishant D Patel, Said C Azoury, Joshua C Grimm, Rosanne B Sheinberg, Christopher M Sciortino
Missile embolus to the heart, although uncommon, is one of the most challenging scenarios in trauma. We describe a 36-year-old man who presented with a gunshot wound to the left chest and a chest x-ray revealing a foreign body in the mediastinum. A median sternotomy was performed and an injury to the left ventricle was identified. After intraoperative echocardiography and fluoroscopy confirmed a foreign body in the aortic root, cardiopulmonary bypass was implemented. A bullet was retrieved from the noncoronary sinus of the aortic valve...
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28429082/the-effect-of-a-combined-thoracic-and-soft-tissue-trauma-on-blood-flow-and-tissue-formation-in-fracture-healing-in-rats
#8
Lutz Claes, Florian Gebhard, Anita Ignatius, Raimund Lechner, Stefan Baumgärtel, Michael Kraus, Gert D Krischak
INTRODUCTION: Previously, it was found that fracture healing is impaired by blunt chest trauma and an additional soft-tissue trauma. The mechanisms leading to this disturbance are largely unknown. Here, we investigated the effect of thoracic and soft-tissue trauma on blood flow of the injured lower leg and on tissue differentiation and callus formation during fracture healing. MATERIALS AND METHODS: Male Wistar rats received either a mid-shaft fracture of the tibia alone (group A), an additional chest trauma (group B), or additional chest and soft-tissue traumas (group C)...
April 20, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28427480/lessons-from-a-large-trauma-center-impact-of-blunt-chest-trauma-in-polytrauma-patients-still-a-relevant-problem
#9
REVIEW
Konstantina Chrysou, Gabriel Halat, Beatrix Hoksch, Ralph A Schmid, Gregor J Kocher
BACKGROUND: Thoracic trauma is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. The purpose of this study was to investigate epidemiological data, treatment and outcome of polytrauma patients with blunt chest trauma in order to help improve management, prevent complications and decrease polytrauma patients' mortality. METHODS: In this retrospective study we included all polytrauma patients with blunt chest trauma admitted to our tertiary care center emergency department for a 2-year period, from June 2012 until May 2014...
April 20, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28427001/emergency-room-thoracotomy-for-acute-traumatic-cardiac-tamponade-caused-by-a-blunt-cardiac-injury-a-case-report
#10
Kenichiro Ishida, Yoshihiro Kinoshita, Nobutaka Iwasa, Masaro Nakae, Masayuki Sakaki, Yohei Ieki, Kyosuke Takahashi, Yumiko Shimahara, Taku Sogabe, Keiichiro Shimono, Mitsuhiro Noborio, Daikai Sadamitsu
INTRODUCTION: Traumatic blunt cardiac injuries have a high mortality rate, and prompt diagnosis and treatment can be lifesaving in cardiac tamponade. PRESENTATION OF CASE: A 62-year-old man was transferred to the emergency department after a motor vehicle accident. He was hemodynamically unstable. A focused assessment with sonography in trauma (FAST) showed pericardial fluid with right ventricular collapse consistent with cardiac tamponade in the subxiphoid view...
April 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28424137/improvement-of-treatment-outcomes-after-implementation-of-a-massive-transfusion-protocol-a-level-i-trauma-center-experience
#11
Andrew Nunn, Peter Fischer, Ronald Sing, Megan Templin, Michael Avery, A Britton Christmas
We assessed the effectiveness of the implementation of an institutional massive transfusion protocol (MTP) for resuscitation with a 1:1:1 transfusion ratio of packed red blood cell (PRBC), fresh frozen plasma, and platelet units. In a Level I trauma center database, all trauma admissions (2004-2012) that received massive transfusions (≥10 units PRBCs in the first 24 hours) were reviewed retrospectively. Demographic data, transfusion ratios, and outcomes were compared before (PRE) and after (POST) MTP implementation in May 2008...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28423132/repair-of-penetrating-pericardial-and-diaphragmatic-injury-with-cormatrix%C3%A2-patch-in-a-case-of-suicide-attempt
#12
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/28422778/ultrasound-as-a-screening-tool-for-central-venous-catheter-positioning-and-exclusion-of-pneumothorax
#13
Rabia Amir, Ziyad O Knio, Feroze Mahmood, Achikam Oren-Grinberg, Akiva Leibowitz, Ruma Bose, Shahzad Shaefi, John D Mitchell, Muneeb Ahmed, Amit Bardia, Daniel Talmor, Robina Matyal
OBJECTIVES: Although real-time ultrasound guidance during central venous catheter insertion has become a standard of care, postinsertion chest radiograph remains the gold standard to confirm central venous catheter tip position and rule out associated lung complications like pneumothorax. We hypothesize that a combination of transthoracic echocardiography and lung ultrasound is noninferior to chest radiograph when used to accurately assess central venous catheter positioning and screen for pneumothorax...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28421890/inmate-health-care-provided-in-an-emergency-department
#14
Lindsey Koester, Jay M Brenner, Aimee Goulette, Susan M Wojcik, William Grant
The United States has the highest rate of incarceration in the world. Many correctional facilities have outsourced the medical care for this population that often presents with complex health issues. This study evaluates the reasons that inmates present to an emergency department (ED) and compares them to the general population ED visits. The most common presenting complaints were trauma (16.8%), abdominal pain (13.5%), chest pain (9.0%), and self-injury (8.7%). These presenting complaints differed significantly from those of the general population (abdominal pain [8...
April 2017: Journal of Correctional Health Care
https://www.readbyqxmd.com/read/28419479/sonographic-diagnosis-of-a-radiographically-occult-displaced-fracture-of-a-costal-cartilage
#15
Chandra Bortolotto, Egisto Federici, Ferdinando Draghi, Stefano Bianchi
We report the case of a 22-year-old athlete who sustained a blunt thoracic trauma to the right chest causing a costal cartilage fracture. Plain radiographs revealed no abnormalities while sonographic (US) examination performed a week later because of persistent pain led to the diagnosis of a displaced fracture of the right tenth costal cartilage. A follow-up US examination confirmed the healing of the fracture and allowed the patient to return to competitive sport activity. We recommend the use of US in patients with persisting pain after thoracic trauma with negative plain radiographs of the ribs to rule out radiographically occult costal cartilage fractures...
April 17, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28414681/what-can-erode-through-lungs-bone-and-skin
#16
J M Manalac, D Shankaranayanan, J Paul-Olivier, L Guidry, N R Sells
CASE: A 51 year old African American Man without significant past history presented with three weeks of persistent cough productive of copious yellow sputum. He denied fevers, chills, hemoptysis, dyspnea, weight or appetite changes, sick contacts, recent travel. On physical examination, the patient was afebrile and appeared comfortable. He had decreased air entry of the left lower lobe with dullness to percussion. A 5x3 cm fluctuant mass was incidentally found on the left anterior chest wall at the level of the 11th rib with yellow expressible exudate at which time the patient reported a minor trauma sustained 3 weeks prior...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28409141/intrathoracic-fracture-dislocation-of-the-humerus-case-report-and-literature-review
#17
Wilson Carlos Sola Junior, Paulo Sérgio Dos Santos
Shoulder fracture-dislocations are uncommon. Those associated with intrathoracic dislocation are very rare conditions, resulting from high-energy trauma; usually, the affected limb is in an abduction position. In Brazil, there is only one report of a teenager with displacement of the epiphysis into the chest cavity; the present is the first adult patient report of intrathoracic dislocation of the humerus. The authors present the case of a patient female, aged 56 years, who was hit by motorcycle and thrown approximately 5 meters away...
March 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28406853/the-role-of-computed-tomography-in-the-classification-of-pediatric-pelvic-fractures-revisited
#18
Bent Ma, Hennrikus Wl, Latorre Je, Armstrong Dg, Shaw B, Jones Kc, Segal Ls
OBJECTIVES: To determine the need of CT scans in the assessment of pediatric pelvic fractures DESIGN:: Retrospective Chart Review SETTING:: Level-1 Pediatric Trauma CenterPatients/Participants: 30 pediatric trauma patients with pelvic fractures who have obtained both a radiograph and CT Scan MAIN OUTCOME MEASUREMENTS:: Fleiss Kappa coefficient to compare inter-reliability. RESULTS: The average age of the patients was 7 years (range 1-13 years). 17 were male and 13 were female...
April 10, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28406388/outcomes-following-traumatic-grain-elevator-injuries
#19
Sydnei Tolefree, Anthony Truong, Jeanette Ward, Fanglong Dong, Elizabeth Ablah, James Haan
OBJECTIVES: The absence of a comprehensive database of grain elevator associated injuries hinders accurate evaluation of injury prevalence and may lead to discordant information about injury frequencies. The main purpose of this study was to identify the most common mechanisms of injury related to grain elevator events. Comparisons of hospital outcomes between patients who sustained traumatic injuries associated with grain elevators at Occupational Safety and Health Administration (OSHA) regulated industrial sites versus those on OSHA exempt farming operations were also made...
April 13, 2017: Journal of Agromedicine
https://www.readbyqxmd.com/read/28400940/early-diagnosis-of-penetrating-cardiac-and-pleural-injury-by-extended-focused-assessment-with-sonography-for-trauma
#20
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
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