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Thoracic trauma

Verena Merki, Juliane Pichler, Roland Giger, Georgios Mantokoudis
BACKGROUND: Chylothorax is a very rare but major complication in thyroid surgery and should be apparent to clinicians in this field. CASE PRESENTATION: We report a case with chylothrax after thyroid surgery in our department that drew our attention. METHODS: Systematic review of the literature to evaluate the incidence and the contributing factors of chylothorax after thyroid surgery. Database (PubMed) and hand searches to identify patients with thyroid surgery and postoperative chylothorax...
October 18, 2016: Journal of Otolaryngology—Head & Neck Surgery
Roger Christopher Gill, K M Inam Pal, Fatima Mannan, Amber Bawa, Saulat H Fatimi
INTRODUCTION: Penetrating oesophageal injuries are extremely rare. Their timely recognition can be difficult and optimal treatment remains controversial. Early recognition of injury is possible with the help of a high index of suspicion and early radiological and endoscopic examinations. Prompt surgical intervention with primary repair of injury, should be the goal. PRESENTATION OF CASES: We describe two cases of penetrating oesophageal trauma where T-Tube placement through the oesophageal defect, was successfully employed...
January 4, 2016: International Journal of Surgery Case Reports
F Bonnaire, M Goepel, P Bula
The requirements of the German statutory accident insurance (DGUV) for the new treatment procedure were presented on 1 January 2013 in a new catalogue. The implementation of the certification of hospitals for the very severe injury procedure (SAV) by the DGUV should have been completed by 2014. These requirements placed high demands on trauma-oriented hospitals because of the high structural and personnel prerequisites. The background to the new organization was the wish of the DGUV for quality improvement in patient treatment in hospitals for patients with very severe occupational and occupation-related trauma by placement in qualified centers with high case numbers...
October 17, 2016: Der Unfallchirurg
Pilar Anton-Martin, Bruno Braga, Stephen Megison, Janna Journeycake, Jessica Moreland
Severe trauma may cause refractory life-threatening respiratory failure requiring extracorporeal membrane oxygenation (ECMO). Concurrent traumatic brain injury, however, complicates the use of ECMO because of the major risk of intracranial bleeding with systemic anticoagulation. Craniotomy and/or craniectomy for hematoma evacuation during ECMO are extremely high-risk procedures secondary to ongoing anticoagulation, and there are only a few such case reports in the literature.We present the case of a child with multiple thoracic injuries and life-threatening respiratory failure supported on ECMO...
October 4, 2016: Pediatric Emergency Care
Aysel Kurt, Hasan Turut, Ahmet Acipayam, Aynur Kirbas, Suleyman Yuce, Medine Cumhur Cure, Erkan Cure
OBJECTIVE: Multiple rib fractures (RFs) and pulmonary contusions (PCs), with resulting systemic lung inflammation, are the most common injuries caused by blunt chest trauma (BCT) in motor vehicle accidents. This study examined levels of the inflammation marker interleukin (IL)-6 and those of the acute-phase reactant surfactant protein (SP)-D in patients with BCT. DESIGN: Prospective, cross-sectional, observational study. SETTING: Single-centre, tertiary care hospital in the Black Sea Region of Turkey...
October 12, 2016: BMJ Open
K M Kurbonov, F I Makhmadov, K R Nazirboev, A A Aminov
AIM: to prove the efficacy and safety of video-assisted techniques in diagnosis and treatment of victims with thoracic and abdominal trauma. MATERIAL AND METHODS: It was analyzed treatment of 249 patients with thoracic (n=82), abdominal (n=122) and thoracoabdominal injuries (n=35) who were divided into 2 groups depending on treatment. Control group of conventional diagnosis and treatment included 130 (52%) patients. Group 2 consisted of 119 (48%) patients in whom differentiated surgical approach combined with current technologies was applied...
2016: Khirurgiia
Zeynep Aslı Kartal, Nalan Kozacı, Bülent Çekiç, İnan Beydilli, Mehmet Akçimen, Dilek Soydam Güven, İclal Erdem Toslak
OBJECTIVE: In this study, emergency physicians and on-call radiologists were compared regarding identification of fatal injuries on computed tomographic (CT) scans in patients with trauma. MATERIALS AND METHODS: Multiply injured patients who were older than 18 years and underwent CT scanning were included in the study. The CT scans were interpreted by the responsible emergency physician. At the same time, these images were also evaluated by the on-call radiologist...
August 24, 2016: American Journal of Emergency Medicine
Ahmad Jabir Rahyussalim, Ifran Saleh, M Fajrin Armin, Tri Kurniawati, Ahmad Yanuar Safri
INTRODUCTION: Intraoperative neurophysiologic monitoring (IONM) had important role related to the complications in spinal surgery. Somatosensory Evoked Potential (SSEP), Transcranial electric Muscle Evoked Potentials (tceMEPs), and free run EMG are parameters used to asses functional integrity of the nervous system during surgical procedures. Once warning signal was recognized, surgeon have to make a precise decision to overcome that problem. PRESENTATION OF CASE: We present a 47-year old male with back pain due to compression fracture of thoracic vertebra T12 and lumbar vertebrae L1...
September 23, 2016: International Journal of Surgery Case Reports
Ioannis Dimovelis, Adamantios Michalinos, Eleftherios Spartalis, Georgios Athanasiadis, Panayiotis Skandalakis, Theodore Troupis
Anatomic variations of axillary artery branches are commonly encountered during radiological investigation and surgical operations. Their existence can confuse interpretation of radiological results and lead to undesired complications during surgery. In this report authors describe a rare case of a subscapular arterial trunk that gave origin to thoracodorsal, circumflex scapular, posterior humeral circumflex, and lateral thoracic artery. Such a variation might cause undesired sequelae during trauma management and a variety of common flap harvesting operations including latissimus dorsi, scapular and parascapular flaps...
October 7, 2016: Folia Morphologica (Warsz)
Peter Stilwell, Katherine Harman, William Hsu, Brian Seaman
BACKGROUND: Musculoskeletal injuries stemming from forceful muscular contractions during seizures have been documented in the literature. Reports of multiple seizure-induced spinal fractures, in the absence of external trauma and without risk factors for fracture, are rare. CASE PRESENTATION: A 28-year-old male, newly diagnosed with epilepsy, presented to a chiropractic clinic with the complaint of mid-thoracic pain beginning after a tonic-clonic seizure with no associated external trauma...
September 2016: Journal of the Canadian Chiropractic Association
Neal S Gerstein, Lindsay J Jinkins, Liem C Nguyen, Timothy M Maus, Todd S Dettmer, Lev Deriy
Aortic rupture and transection are constituents of the acute aortic syndrome. Injury to the thoracic aorta during motor vehicle crashes is associated with blunt chest trauma and rapid deceleration mechanisms. Type A dissections and/or rupture of the aorta at the level of the aortic isthmus are the more common presentations of aortic injuries associated with motor vehicle crashes. We present the case of atypical echocardiographic findings of a nearly complete circumferential transection of the proximal ascending aorta injury after a motorcycle crash...
October 4, 2016: Echocardiography
D Tchin, W Atsi, T Hodabalo Tchaa, Kpelao Essossinam, J Yaovii Edèm, K Koffi Amégbor, N-K Gado
We collected 190 forensic records from the only pathology laboratory in Lomé, over the period from January 2010 to December 2014. The sex ratio (M/F) was 4.4 and the decedents' average age 33.4 years. In 43.2% of cases, the accident resulted from a collision between a pedestrian and a motorcycle; excess speed noted in 56.8% of cases. Four principal groups of fatal injuries were observed: polytrauma (136 cases), isolated severe head injury (49 cases), isolated thoracic contusion (3 cases), and abdominal pelvic contusion with perinea trauma (2 cases)...
August 1, 2016: Médecine et Santé Tropicales
Prashanth J Rao, Kevin Phan, Ralph J Mobbs, David Wilson, Jonathon Ball
BACKGROUND: Immobilization of the cervical spine is a cornerstone of spinal injury management. In the context of suspected cervical spine injury, patients are immobilized in a 'neutral position' based on the head and trunk resting on a flat surface. It is hypothesized that the increased thoracic kyphosis and loss of cervical lordosis seen in elderly patients may require alternative cervical immobilization, compared with the 'neutral position'. METHODS: To investigate this, an audit of pan-scan CT performed on consecutive major trauma patients aged over 65 years was carried out over a 6-month period...
March 2016: J Spine Surg
Sana Salah, Houda Migaou, Zied Belaaj, Soumaya Boudokhane, Anis Jellad, Abderrazak Abid, Zohra Ben Salah Frih
OBJECTIVE: Winging of the scapula has a variety of causes and a variable prognosis. It contributes to a disruption of the scapulohumeral rhythm with a decreased flexion and abduction of the upper extremity and a source of a considerable pain. This condition can affect the ability to perform activities of daily living. The most common cause of scapula winging is serratus anterior paralysis resulting from a lesion of the long thoracic nerve. The rupture of the muscle itself remains uncommon...
September 2016: Annals of Physical and Rehabilitation Medicine
Kyla D Joubert, Charles D Mabry, Kyle J Kalkwarf, Richard D Betzold, Horace J Spencer, Kara M Spinks, Austin Porter, Saleema Karim, Ronald D Robertson, Michael J Sutherland, Robert T Maxson
Major trunk trauma is common and costly, but comparisons of costs between trauma centers (TCs) are rare. Understanding cost is essential to improve quality, manage trauma service lines, and to facilitate institutional commitment for trauma. We have used results of a statewide trauma financial survey of Levels I to IV TC to develop a useful grouping method for costs and clinical characteristics of major trunk trauma. The trauma financial survey collected billing and clinical data on 75 per cent of the state trauma registry patients for fiscal year 2012...
September 2016: American Surgeon
Jacqui Agostinello, Camila R Battistuzzo, Peta Skeers, Stephen Bernard, Peter E Batchelor
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The aims of this study were to (1) determine the timing of surgery for traumatic TLSCI between 2010 and 2014 and (2) identify major delays in the process of care from accident scene to surgery. SUMMARY OF BACKGROUND DATA: Early spinal surgery may promote neurological recovery and reduce acute complications after thoracolumbar spinal cord injury (TLSCI), however it is difficult to achieve due to logistical issues and the frequent presence of other non-life threatening injuries...
September 23, 2016: Spine
Natalie Behrle, Peter Dyke, Abdallah Dalabih
Motor vehicle accident is the most common cause of blunt cardiac injury (BCI) in children (85.3%) due to the height of the child in relation to proper restraints and the compliant pediatric rib cage (J Trauma. 1996;40:200-202). Trauma to the chest wall may lead to injury of the myocardium, resulting in myocardial contusion, ventricular septal defect (VSD), ventricular free wall rupture, or valve compromise (J Trauma. 1996;40; 200-202; Heart Lung. 2012;41:200-202; J Inj Violence Res. 2012;4:98-100). There are several proposed mechanisms for the formation of VSD after blunt chest trauma including rupture of ischemic myocardium related to the initial trauma and reopening of a spontaneously closed congenital VSD...
September 23, 2016: Pediatric Emergency Care
Jack W Rostas, Timothy B Lively, Sidney B Brevard, Jon D Simmons, Mohammad A Frotan, Richard P Gonzalez
BACKGROUND: The purpose of this study was to identify patients with rib injuries who were at risk for solid organ injury. METHODS: A retrospective chart review was performed of all blunt trauma patients with rib fractures during the period from July 2007 to July 2012. Data were analyzed for association of rib fractures and solid organ injury. RESULTS: In all, 1,103 rib fracture patients were identified; 142 patients had liver injuries with 109 (77%) associated right rib fractures...
August 28, 2016: American Journal of Surgery
Aleksandr Rozenberg, Jonathan C Weinstein, Adam E Flanders, Pranshu Sharma
Reformatted CTs of the thoracic and lumbar spine (CT T/L) from CTs of the chest, abdomen, and pelvis (CT body) may be performed for screening the thoracolumbar spine in patients sustaining blunt trauma. The purpose of this study was to determine whether there was a difference in the rate of detection of spinal fractures on CTs of the body compared to the reformatted T/L spine. A secondary endpoint was to evaluate whether cases dictated by trainees improved fracture detection rate. We reviewed the records of 250 consecutive blunt trauma patients that received CTs of the chest, abdomen, and pelvis (CT body) with concurrent CT T/L reformats...
September 23, 2016: Emergency Radiology
Christopher Bell, Fernando Domingo, Ashley D Miller, Jeremiah S Smith, James R Headrick
We report a case of a posterior mediastinal mature cystic teratoma with rupture secondary to blunt chest trauma in a 20-year-old male involved in a motor-vehicle accident. Initial treatment was guided by Advanced Trauma Life Support and a tube thoracostomy was performed for presumed hemothorax. The heterogeneous collection within the thoracic cavity was discovered to be the result of a ruptured cystic mass. Pathologic findings confirmed the mass consistent with a mature cystic teratoma. As mediastinal teratomas are most commonly described arising from the anterior mediastinum, the posterior location of the teratoma described in this report is exceedingly rare...
2016: Case Reports in Surgery
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