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chest x ray multiple trauma

Shayna C Rivard, Elizabeth Satter
A 31-year-old Filipino active duty marine presented with a 2-year history of a waxing and waning nodule on his left cheek that had been incised and drained on multiple occasions. The patient had no significant medical history other than a positive purified protein derivative test with negative chest x-ray finding treated with a 9-month course of isoniazid in 2010. He denied cough, fever, chills, night sweats, weight loss, joint/bone pain, or prior trauma to the area. On initial examination, there was a 1×1-cm erythematous indurated nodule associated with an overlying violaceous scar on his left preauricular cheek...
2016: Skinmed
Baig M Idris, Ashraf F Hefny
INTRODUCTION: Pneumothorax is the most common potentially life-threatening blunt chest injury. The management of pneumothorax depends upon the etiology, its size and hemodynamic stability of the patient. Most clinicians agree that chest drainage is essential for the management of traumatic large pneumothorax. Herein, we present a case of large pneumothorax in blunt chest trauma patient that resolved spontaneously without a chest drain. PRESENTATION OF CASE: A 63- year- old man presented to the Emergency Department complaining of left lateral chest pain due to a fall on his chest at home...
2016: International Journal of Surgery Case Reports
Hendrik Wyen, Sebastian Wutzler, Miriam Rüsseler, Martin Mack, Felix Walcher, Ingo Marzi
BACKGROUND: A regionalized approach to trauma care with the implementation of designated level I trauma centers has been shown to improve survival after multiple injuries. Our study aimed to describe the current reality in an urban German level I university trauma center concerning the primary admission of patients into the emergency room. MATERIALS AND METHODS: We performed a retrospective analysis of all multiple trauma patients that were prospectively documented in our documentation system TraumaWatch(®) from 2003 to 2007...
October 2009: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Abdel-Mohsen M Hammad, Mohamed A Regal
STUDY: New generation spiral CT scanners permit multiple consecutive CT examinations on the same trauma patient in a short period of time. The purpose of this study was to evaluate the diagnostic role and therapeutic impact of routine spiral CT chest in multiply injured patients or patients with a suspicious mechanism of injury. PATIENTS AND METHODS: This prospective study included 443 patients with blunt chest trauma. All patients underwent a spiral CT chest as part of their routine evaluation...
February 2009: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Tetsuya Yumoto, Keiji Sato, Toyomu Ugawa, Yoshihito Ujike
An 83-year-old woman with no significant medical history was transferred to our tertiary hospital after being hit by a car and presenting with haemorrhagic shock. Immediate fluid resuscitation was performed; physical, chest/pelvic X-ray and echographic examinations did not detect any major sources of bleeding. However, a contrast-enhanced CT scan revealed multiple regions of significant contrast extravasation in an extensive part of the subcutaneous tissue of the patient's lower back, which is an unusual source of bleeding...
2015: BMJ Case Reports
Meera Subash, Gaurav Patel, John Welker, Kenneth Nugent
Background. Brachial neuritis (BN) is a rare inflammatory condition of peripheral nerves, usually involving the cervicobrachial plexus. These patients present with sudden onset of shoulder and arm pain that evolves into muscle weakness and atrophy.. Case Report. A 33-year-old woman presented with a 1-month history of diffuse pain in her thorax. She had no trauma or inciting incident prior to the onset of this pain and was initially treated for muscle spasms. The patient was seen in the emergency room multiple times and was treated with several courses of antibiotics for pneumonia on the basis of clinical symptoms and abnormal x-rays...
April 2014: Journal of Investigative Medicine High Impact Case Reports
Nushin Moussavi, Abdol Hossein Davoodabadi, Fatemeh Atoof, Seyed Ebrahim Razi, Mehdi Behnampour, Hamid Reza Talari
BACKGROUND: Computerized Tomography (CT) scan is gaining more importance in the initial evaluation of patients with multiple trauma, but its effect on the outcome is still unclear. Until now, no prospective randomized trial has been performed to define the role of routine chest CT in patients with blunt trauma. OBJECTIVES: In view of the considerable radiation exposure and the high costs of CT scan, the aim of this study was to assess the effects of performing the routine chest CT on the outcome as well as complications in patients with blunt trauma...
June 2015: Archives of Trauma Research
R K Mohammed, S Cheung, S P Parikh, K Asgaria
Aortic arch injuries following penetrating trauma are typically lethal events with high mortality rates. Traditionally, the standard of care for patients presenting with penetrating injury and aortic involvement has included surgical intervention. We report the case of a 31-year-old man who was managed non-operatively after sustaining multiple stab wounds to the left chest and presenting with mid aortic arch injury.
April 2015: Annals of the Royal College of Surgeons of England
L Shannon, T Peachey, N Skipper, E Adiotomre, A Chopra, B Marappan, N Kotnis
AIM: To assess the accuracy of the trauma team leader's clinical suspicion of injury in patients who have undergone whole-body computed tomography (WBCT) for suspected polytrauma, and to assess the frequency of unsuspected injuries and specific patterns of injury at WBCT. MATERIALS AND METHODS: Requests for patients who underwent WBCT for suspected polytrauma from April 2011 to March 2014 were reviewed and each body area that was clinically suspected to be injured was recorded...
November 2015: Clinical Radiology
Mark I Langdorf, Anthony J Medak, Gregory W Hendey, Daniel K Nishijima, William R Mower, Ali S Raja, Brigitte M Baumann, Deirdre R Anglin, Craig L Anderson, Shahram Lotfipour, Karin E Reed, Nadia Zuabi, Nooreen A Khan, Chelsey A Bithell, Armaan A Rowther, Julian Villar, Robert M Rodriguez
STUDY OBJECTIVE: Chest computed tomography (CT) diagnoses more injuries than chest radiography, so-called occult injuries. Wide availability of chest CT has driven substantial increase in emergency department use, although the incidence and clinical significance of chest CT findings have not been fully described. We determine the frequency, severity, and clinical import of occult injury, as determined by changes in management. These data will better inform clinical decisions, need for chest CT, and odds of intervention...
December 2015: Annals of Emergency Medicine
H Ulutas, M R Celik, M Ozgel, O Soysal, A Kuzucu
PURPOSE: Traumatic pulmonary pseudocysts (TPPs) are rare complications of chest trauma. The aim of this retrospective study was to report the clinical presentations, diagnosis, complications and treatment for a series of TPPs at a hospital in Turkey. METHODS: The charts of 996 patients who were admitted for thoracic trauma between 1999 and 2012 were retrospectively reviewed. Fifty-two patients had TPPs, and the data collected for these individuals were sex, age, and type of trauma (blunt and/or penetrating)...
April 2015: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Ana Lilia Nolasco-de la Rosa, Roberto Mosiñoz-Montes, Jesús Matehuala-García, Edgardo Román-Guzmán, Fidel Quero-Sandoval, Alma Lorena Reyes-Miranda
BACKGROUND: Flail chest is managed with mechanical ventilation or inhalation therapy, and analgesia. Mechanical ventilations carry risks by themselves and disengage with the external fixators so they must be operated to improve lung ventilatory mechanics and cleaning. Little has been published on the use of bioabsorbable material and its evolution in the setting of flail chest. MATERIAL AND METHODS: A material that did had to be retired, that presented the malleability of titanium and its inflammatory reaction was minimal and could be handled in both adults and children was investigated...
January 2015: Cirugia y Cirujanos
Umer Hasan Bhatti, Surrendar Dawani
Posttraumatic diaphragmatic hernia is a rare cause of large bowel obstruction, and can present weeks or years after the initial trauma. Herein, we report the case of a 28-year-old man who presented with signs and symptoms of bowel obstruction nine months after he had a stab wound to his left chest. Chest radiography showed multiple air‑fluid levels in the right upper quadrant, an air-fluid level in the left thoracic cavity and significant free air under the diaphragm. Exploratory laparotomy revealed a contaminated abdomen with perforations in the caecum and proximal transverse colon, and a 4 cm × 4 cm defect in the left posterolateral (septal) aspect of the diaphragm, which was closed with a nonabsorbable suture...
April 2015: Singapore Medical Journal
Jinming Chen, Jin Yan, Shenhua Wang, Huiming Zhong, Haibo Zhou
High-energy trauma to the shoulder is associated with multiple injuries and is often difficult to evaluate. One of these complex traumas is the displacement of the humeral head into the thoracic cavity. This study aimed to report a patient who presented after falling three floors. Initially, the patient underwent chest drainage and thoracoscopy to remove the displaced humeral head and, subsequently, underwent delayed artificial humeral head replacement. Hemodynamic stability, systematic evaluation, removal of the humeral head, and individual shoulder reconstruction are recommended for these patients...
March 2015: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Akira Naomi, Yoshinori Oyamatsu, Kunio Narita, Masato Nakayama
In Japan, we are permitted to own fire arms only for hunting and clay pigeon shooting, but gunshot wound victims have neen rarely seen due to the strict laws against owing guns, and the lack of related crimes. Therefore, surgeons should be familiar with ballistics, practical gunshot wound management, and the possibility of delayed lead poisoning ssociated with bullet residue. A 69-year-old man was brought to our hospital because he was accidentally shot by his companion's shotgun during hunting. On admission, although he had stable vital sign and multiple gunshot wounds on his right forearm and femur, chest X-ray and computed tomography (CT) revealed a few of bullets and its flagments on his back, into spleen and pericardium...
February 2015: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Julius Renne, Christin Linderkamp, Frank Wacker, Lars-Daniel Berthold, Jürgen Weidemann
OBJECTIVES: To assess the prevalence and morphologic characterization of pulmonary nodules in children on a chest computed tomography (CT). METHODS: Two hundred and fifty-nine trauma chest CTs in children aged 0-18 years were retrospectively reviewed by two radiologists, each with more than 10 years of experience. Images were acquired on a 64-row CT. Pulmonary lobes with trauma affections such as contusion or haemorrhage were excluded. All pulmonary nodules were evaluated for distance from the pleural surface, location, calcification and size on axial slices...
September 2015: European Radiology
Seyyed Hossein Ojaghi Haghighi, Ida Adimi, Samad Shams Vahdati, Reza Sarkhoshi Khiavi
BACKGROUND: Bleeding and trapped air in the pleural space are called hemothorax and pneumothorax, respectively. In cases where there are delays in diagnosis and treatment, the mortality rates due to hemopneumothorax can be significant. Hemopneumothorax is characterized by decreased lung sounds or chest percussion and subcutaneous emphysema. Diagnosis of pneumothorax and hemothorax can be achieved by portable chest X-ray (CXR), computed tomography (CT) scan, or ultrasonography. Portable CXR and CT-scans have their individual drawbacks...
November 2014: Trauma Monthly
Benjamin R Pulley, Benjamin C Taylor, Terry Ty Fowler, Neysa Dominguez, Thai Q Trinh
BACKGROUND: Surgical stabilization of flail chest is increasingly recognized as a valid approach to improve pulmonary mechanics in selected trauma patients. The use of two-dimensional (2D) computed tomography (CT) has become almost universal in the assessment of blunt chest trauma and multiple rib fractures. We hypothesized that three-dimensional (3D) CT adds valuable information to the preoperative plan for fixation of rib fractures. METHODS: Using a retrospective cohort of 35 consecutive adult patients with flail chest requiring surgery, we evaluated the intraobserver and interobserver reliability of plain radiographs, 2D CT and 3D CT, for the identification of rib fractures and identified how often the surgical plan changed with the addition of the information provided by the 3D CT...
March 2015: Journal of Trauma and Acute Care Surgery
Helmut Ringl, Mathias Lazar, Michael Töpker, Ramona Woitek, Helmut Prosch, Ulrika Asenbaum, Csilla Balassy, Daniel Toth, Michael Weber, Stefan Hajdu, Grzegorz Soza, Andreas Wimmer, Thomas Mang
OBJECTIVE: To assess a radiologist's detection rate of rib fractures in trauma CT when reading curved planar reformats (CPRs) of the ribs compared to reading standard MPRs. METHODS: Two hundred and twenty trauma CTs (146 males, 74 females) were retrospectively subjected to a software algorithm to generate CPRs of the ribs. Patients were split into two equal groups. Sixteen patients were excluded due to insufficient segmentation, leaving 107 patients in group A and 97 patients in group B...
July 2015: European Radiology
S Gordic, H Alkadhi, S Hodel, H-P Simmen, M Brueesch, T Frauenfelder, G Wanner, K Sprengel
OBJECTIVE: To determine the number of imaging examinations, radiation dose and the time to complete trauma-related imaging in multiple trauma patients before and after introduction of whole-body CT (WBCT) into early trauma care. METHODS: 120 consecutive patients before and 120 patients after introduction of WBCT into the trauma algorithm of the University Hospital Zurich were compared regarding the number and type of CT, radiography, focused assessment with sonography for trauma (FAST), additional CT examinations (defined as CT of the same body regions after radiography and/or FAST) and the time to complete trauma-related imaging...
March 2015: British Journal of Radiology
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