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https://www.readbyqxmd.com/read/27920844/popliteal-artery-embolism-of-bullet-after-abdominal-gunshot-wound
#1
Junjian Huang, Vivek Pandey, Rohan Shah, Vivek Yedavalli, Anand Joshi, Roger Stimpson, Mark Keldahl, Loren Zuiderveld
Bullet embolism to the peripheral arterial system is a rare phenomenon which frequently results in misdiagnosis due to lack of early symptoms. Embolisms can go to either arterial or venous systems with common sites of injury including the left ventricle, pulmonary vein, thoracic and abdominal aorta and peripheral arteries. Herein we present a case of a 19 year old patient with multiple gunshot wounds to the torso with a bullet embolism to the left popliteal artery necessitating embolectomy. This subsequently led to diagnosis and repair of an abdominal aortic psuedoaneurysm not clearly evident on initial imaging...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27858523/laparoscopic-assisted-approach-for-penetrating-abdominal-trauma-an-underutilized-technique
#2
Modise Z Koto, Oleh Y Matsevych, Colleen Aldous
INTRODUCTION: Diagnostic laparoscopy is well accepted in the management of penetrating abdominal trauma (PAT). Therapeutic laparoscopy, on the other hand, remains controversial. In patients with multiple hollow viscera injuries, laparoscopy is usually converted to laparotomy. We aim at describing the laparoscopic-assisted technique in the management of patients with PAT. Using our experience with laparoscopy, we tailored the technique to the setting of PAT. METHODS: The laparoscopic-assisted approach (LAA) was adapted to a trauma setting and prospectively evaluated...
November 18, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27833712/partially-thrombosed-internal-maxillary-pseudoaneurysm-after-gunshot-wound
#3
Menachem Gold
A 29-year-old man arrived in our emergency department after being shot on the face. Computed tomography (CT) revealed multiple facial bone fractures along the bullet trajectory. On day 10 of admission, CT angiogram of the neck revealed a partially thrombosed pseudoaneurysm in the parapharyngeal fat pad. The pseudoaneurysm was successfully treated with coil embolization. This report discusses diagnosis and treatment of a partially thrombosed internal maxillary artery pseudoaneurysm. Although digital subtraction angiography is the gold standard for pseudoaneurysm diagnosis, CT angiography may provide complimentary information, as seen in this case...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27798535/urinary-biomarkers-are-associated-with-severity-and-mechanism-of-injury
#4
Jud C Janak, Ian J Stewart, Jonathan A Sosnov, Jeffrey T Howard, Edward D Siew, Mallory M Chan, Nancy Wickersham, T Alp Ikizler, Kevin K Chung
Combat-related blast trauma results in massive tissue injury and tends to involve multiple systems. Further, an acute measure of injury severity based on underlying biological mechanisms may be important for the triage and treatment of these types of patients. We hypothesized that urinary biomarkers (UBs) would reflect severity of injury and that they would be elevated for blast injuries compared to gunshot wounds (GSW) in a cohort of combat casualties. We also postulated that UBs would be higher in patients with burns compared to patients with non-burn trauma in a civilian cohort...
October 26, 2016: Shock
https://www.readbyqxmd.com/read/27742157/sentinel-events-preceding-youth-firearm-violence-an-investigation-of-administrative-data-in-delaware
#5
Steven A Sumner, Matthew J Maenner, Christina M Socias, James A Mercy, Paul Silverman, Sandra P Medinilla, Steven S Martin, Likang Xu, Susan D Hillis
INTRODUCTION: Accurately identifying youth at highest risk of firearm violence involvement could permit delivery of focused, comprehensive prevention services. This study explored whether readily available city and state administrative data covering life events before youth firearm violence could elucidate patterns preceding such violence. METHODS: Four hundred twenty-one individuals arrested for homicide, attempted homicide, aggravated assault, or robbery with a firearm committed in Wilmington, Delaware, from January 1, 2009 to May 21, 2014, were matched 1:3 to 1,259 Wilmington resident controls on birth year and sex...
September 8, 2016: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/27734452/a-case-of-prehospital-traumatic-arrest-in-a-us-special-operations-soldier-care-from-point-of-injury-to-full-recovery
#6
Myles R McKenzie, Ernest W Parrish, Ethan A Miles, James C Spradling, Lanny F Littlejohn, Mark D Quinlan, George A Barbee, David R King
During an assault on an extremely remote target, a US Special Operations Soldier sustained multiple gunshot and fragmentation wounds to the thorax, resulting in a traumatic arrest and subsequent survival. His care, including care under fire, tactical field care, tactical evacuation care, and Role III, IV, and V care, is presented. The case is used to illustrate the complex dynamics of Special Operations care on the modern battlefield and the exceptional outcomes possible when evidence-based medicine is taken to the warfighter with effective, farforward, expeditionary medical-force projection...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/27727041/oculocardiac-reflex-as-a-result-of-intraorbital-trauma
#7
Joel M Fahling, L Kendall McKenzie
BACKGROUND: The oculocardiac reflex is a decrease in heart rate caused by ocular compression or traction upon the extraocular musculature. Multiple instances of this phenomenon have been described in anesthesia, trauma, craniofacial, and ophthalmology literature, but there is a sparsity of documentation in the emergency medicine literature. CASE REPORT: We describe the observation and management of the oculocardiac reflex in a 26-year-old man with retrobulbar hematoma and intraocular trauma caused by a self-inflicted gunshot wound...
October 8, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27723646/surgical-correction-of-severe-enophthalmos-caused-by-bullet-injury
#8
S M Balaji
Ballistic injuries of oral and maxillofacial region are usually fatal due to close propinquity with the vital structures. The severity of injury depends on the caliber of the weapon used and distance from which the patient is shot. The preliminary care of facial ballistic wounds strictly adheres to the basics of trauma resuscitation. Early and appropriate surgical management has proved to be influential on the final outcome and esthetic result. Treatment of facial gunshot wounds should be planned and carried out carefully to avoid esthetic complications...
July 2016: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
https://www.readbyqxmd.com/read/27671737/is-early-appropriate-care-of-axial-and-femoral-fractures-appropriate-in-multiply-injured-elderly-trauma-patients
#9
M S Reich, A J Dolenc, T A Moore, H A Vallier
BACKGROUND: Previous work established resuscitation parameters that minimize complications with early fracture management. This Early Appropriate Care (EAC) protocol was applied to patients with advanced age to determine if they require unique parameters to mitigate complications. METHODS: Between October 2010 and March 2013, 376 consecutive skeletally mature patients with unstable fractures of the pelvis, acetabulum, thoracolumbar spine, and/or proximal or diaphyseal femur fractures were treated at a level I trauma center and were prospectively studied...
September 26, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27648655/useful-method-for-intraoperative-monitoring-of-facial-nerve-in-a-scarred-bed
#10
Bilge Kagan Aysal, Abdulkerim Yapici, Yalcin Bayram, Fatih Zor
Facial nerve is the main cranial nerve for the innervation of facial expression muscles. Main trunk of facial nerve passes approximately 1 to 2 cm deep to tragal pointer. In some patients, where a patient has multiple operations, fibrosis due to previous operations may change the natural anatomy and direction of the branches of facial nerve. A 22-year-old male patient had 2 operations for mandibular reconstruction after gunshot wound. During the second operation, there was a possible injury to the marginal mandibular nerve and a nerve stimulator was used intraoperatively to monitor the nerve at the tragal pointer because the excitability of the distal segments remains intact for 24 to 48 hours after nerve injuries...
October 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27578384/reconstruction-and-rehabilitation-of-short-range-gunshot-injury-to-lower-part-of-face-a-systematic-approach-of-three-cases
#11
Ashutosh Vatsyayan, Apurba-Kumar Adhyapok, Subhas-Chandra Debnath, Kapil Malik
Gunshot injuries are always known to cause severe morbidity and mortality when head and neck are involved. They vary in morbidity, which can occur in civilian surroundings. The wound largely depends on the type of weapon, mass and velocity of the bullet, and the distance from where it has been shot. Close-range gunshot wounds in the head and neck region can result in devastating aesthetic and functional impairment. The complexity in facial skeletal anatomy cause multiple medical and surgical challenges to an operating surgeon, demanding elaborate soft and hard tissue reconstruction...
August 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/27553197/penetrating-thoracic-trauma-patients-with-gross-physiological-derangement-a-responsibility-for-the-general-surgeon-in-the-absence-of-trauma-or-cardiothoracic-surgeon
#12
Dietrich Doll, Markus Eichler, Pantelis Vassiliu, Kenneth Boffard, Tim Pohlemann, Elias Degiannis
BACKGROUND: Penetrating trauma is becoming increasingly common in parts of the world where previously it was rare. At the same time, general surgeons and surgical trainees are becoming more specialized, and less comfortable operating within areas beyond their zone of specialization. OBJECTIVE: The purpose of this manuscript is to assess the technical difficulties encountered in operating on patients who have sustained penetrating trauma, and to prove to general surgeons that the technical skills and techniques required are no different to those required for abdominal surgery, and do not require additional dexterity...
August 23, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27552704/evaluation-of-trauma-patterns-in-blast-injuries-using-multiple-correspondence-analysis
#13
Marie Christine Dussault, Martin Smith, Ian Hanson
Anthropology features little in published literature about blast injuries. Contributions through case studies and experimental research are beginning to expand our understanding of the effect these injuries have on the human skeleton. This study examines blast injury and gunshot related fractures through multiple correspondence analysis (MCA) with the aim of establishing injury patterns between the two types of trauma. Using a sample of 491 individuals from Bosnia, MCA is employed to identify which body regions differentiate between blast or gunshot related fractures...
October 2016: Forensic Science International
https://www.readbyqxmd.com/read/27493261/scintigraphic-diagnosis-of-intrathoracic-splenic-implants-masquerading-as-malignancy
#14
REVIEW
Paul D Rodrigue, Asif A Fakhri, Jin T Lim
After significant trauma to the spleen, small viable splenic fragments may exist in the peritoneal cavity or, less commonly, in the thorax. Thus, the appearance of splenules within the thorax on CT images can easily be mistaken for malignancy and lead to unnecessary intervention. Here, we present a case of multiple pulmonary masses that initially were presumed to be malignancy, leading to CT-guided biopsy, but were eventually confirmed to be thoracic splenules through (99m)Tc-labeled sulfur colloid scintigraphy...
December 2016: Journal of Nuclear Medicine Technology
https://www.readbyqxmd.com/read/27451895/risk-factors-for-recurrent-violent-injury-among-black-men
#15
Joseph B Richardson, Christopher St Vil, Tanya Sharpe, Michael Wagner, Carnell Cooper
BACKGROUND: Black men are disproportionately overrepresented among victims of repeat violent injury. However, little is known about the risk factors that influence violent trauma recidivism among black men. We hypothesize that the following risk factors would be significant among black male victims of repeat violent injury: disrespect; being under the influence; being in a fight and using a weapon in the past year; and previous incarceration when comparing trauma recidivists versus nonrecidivists...
July 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27422800/-epidemiology-of-gunshot-wounds-in-the-university-hospital-dr-jos%C3%A3-eleuterio-gonz%C3%A3-lez-of-the-autonomous-university-of-nuevo-le%C3%A3-n
#16
José Canseco Cavazos, Jorge Palacios-Zertuche, Francisco Reyna-Sepúlveda, Neri Álvarez-Villalobos, Louisiana Alatorre-López, Gerardo Muñoz-Maldonado
BACKGROUND: The incidence of deaths and injuries associated with gunshot wounds deserves special attention, mainly because of its repercussions on hospital resources and the diagnosis and treatment protocols. OBJECTIVE: To perform an analysis on the epidemiological factors associated with gunshot wounds. MATERIAL AND METHODS: An analysis was made of multiple variables of all patients diagnosed with gunshot wounds during the period between 2005 and 2015...
July 12, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/27330926/single-operation-to-repair-multifocal-cerebrospinal-fluid-fistulae-following-gunshot-wound-a-case-report
#17
Gabrielle A White-Dzuro, Pouya Entezami, George Wanna, Paul Russell, Lola B Chambless
Introduction Traumatic cerebrospinal fluid (CSF) fistulae can be a challenging neurosurgical disease, often requiring complicated surgical intervention. Case Presentation A 54-year-old man presented with a gunshot wound to the head with complex injury to the skull base and significant CSF leakage from multiple sites. A single surgery was performed using a combined Neurosurgery, Neurotology, and Rhinology team, which was successful in repairing the multiple skull base defects and preventing further CSF leak...
June 2016: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/27071317/retained-lumbar-bullet-a-case-report-of-chronic-lead-toxicity-and-review-of-the-literature
#18
Nirma D Bustamante, Wendy L Macias-Konstantopoulos
BACKGROUND: Lead toxicity from retained bullet fragments is difficult to both predict and diagnose, but important to treat early, given the potential severity of disease. Blood lead levels > 25 μg/dL and 40 μg/dL are considered toxic in children and adults, respectively. Symptoms may range from nonspecific constitutional symptoms to seizures and coma. Chelation is the mainstay therapy for lead poisoning and levels to treat depend on patient age, blood lead levels, and the presence of symptoms...
July 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27032010/pediatric-gunshot-wound-recidivism-identification-of-at-risk-youth
#19
Peter D Gibson, Joseph A Ippolito, Mohammed Kareem Shaath, Curtis L Campbell, Adam D Fox, Irfan Ahmed
BACKGROUND: Although penetrating injury is the most common reason for pediatric trauma recidivism, there is a paucity of literature specifically looking at this population. The objective of this study was to identify those in the pediatric community at the highest levels of risk for experiencing gunshot wound (GSW) on multiple occasions. METHODS: A retrospective review querying our urban Level I trauma database was performed. Patients aged 0 year to 18 years sustaining GSW from 2000 to 2011 were selected...
June 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26948690/retrospective-analysis-of-case-series-of-patients-with-vascular-war-injury-treated-in-a-district-hospital
#20
Tal Salamon, Alexander Lerner, David Rothem, Alexander Altshuler, Ron Karmeli, Evgeny Solomonov, Seema Biswas
INTRODUCTION: As the Syrian civil war continues, medical care of the injured remains a priority for health facilities receiving casualties. Ziv Medical Centre, the closest hospital in Israel to the Syrian border, has received 500 casualties since February 2013. Seventeen of these patients had vascular injuries. This research reports the care of these seventeen patients and explores the challenges of treatment in patients with little antecedent clinical history and improvised initial care that may be complicated by delay to definitive care, sepsis and limb ischaemia...
April 2016: Injury
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