trauma haemorrhage

Wunderlich syndrome (WS) is characterized by spontaneous renal or perinephric hemorrhage in the absence of known trauma. WS is much rarer than haemorrhage caused by iatrogenic or traumatic conditions. The classic WS presentation of Lenk's triad of acute onset flank pain, flank mass, and hypovolemic shock is seen in less than a quarter of patients. The majority of patients present with only isolated flank pain and are frequently imaged in the emergency department with an unenhanced computed tomography (CT). The underlying aetiology varies, with the majority of cases attributed to neoplasms, vascular disease, cystic renal disease, and anticoagulation...

Diaphyseal forearm fractures are typically treated with open reduction and plate fixation, which has been proven to be the most effective method in numerous trials. However, the risk of periosteal stripping, haemorrhage evacuation, nonunion, and infection is always present and may cause a delayed union and other surgical consequences. Although intramedullary nails have been mentioned in the literature for forearm bone fractures, issues regarding their common complication of nail migration, especially of the ulnar fracture, before the fracture has been consolidated is an issue, and has not been addressed...

The second stage of labour includes both the passive and active stages, involving expulsive efforts. The management of this phase of labour aims to minimise the maternal and neonatal complications that could be associated with a prolonged active2nd stage, but also to limit medical interventions.On the maternal side, prolonged duration of expulsive effort appears to be correlated with increased postpartum haemorrhage, perineal injury and, in the long term, urinary and anal incontinence. From a neonatal viewpoint, expulsive efforts carry risks of neonatal acidosis, asphyxia, admission to the neonatal intensive care unit and trauma...

Subclavian artery injuries are sporadic, and the most common aetiology is trauma. Self-injury of the vessel in those misusing intravenous drugs is a rare complication, as most reports describe injury to the femoral artery. Thus, erosion and potential rupture of the arterial wall is possible due infection and phlegmon or abscess formation. We present a case of a young, female, hemodynamically unstable intravenous drug user admitted to the emergency department with a life-threatening, purulent haemorrhagic mass located at her right lateral cervical region...

Page kidney is a condition where external compression of the renal artery and renal parenchyma leads to subsequent ischaemia and activation of renin-angiotensin-aldosterone axis. A 42-year-old female with hirsutism, hypertension and diabetes was diagnosed with a right adrenal mass and underwent laparoscopic adrenalectomy. Her hypertension worsened postoperatively and was managed medically. Subsequently she developed a right flank pain on the fifth postoperative day and died suddenly the next day. Autopsy revealed a pale body with cushingoid appearance...

Trauma is a significant health issue that not only leads to immediate death in many cases but also causes severe complications, such as sepsis, thrombosis, haemorrhage, acute respiratory distress syndrome and traumatic brain injury, among trauma patients. Target protein identification technology is a vital technique in the field of biomedical research, enabling the study of biomolecular interactions, drug discovery and disease treatment. It plays a crucial role in identifying key protein targets associated with specific diseases or biological processes, facilitating further research, drug design and the development of treatment strategies...

Corona mortis (CM) is an anastomotic vessel between the inferior epigastric or external iliac vessels and the obturator or internal iliac vessels. The Latin meaning of it is 'crown of death' which corresponds to massive haemorrhage caused by injury to this vessel during surgery. The incidence of this vessel is around 50% in the hemipelvis. We are presenting an intraoperative video of a right laparoscopic totally extraperitoneal mesh hernioplasty demonstrating a CM artery in the right hemipelvis. Care was taken to prevent injury to this vessel...

BACKGROUND AND OBJECTIVE: Ageing is associated with an increased risk of falls and trauma. The aim of the study was to assess the characteristics of patients over 65 years of age who consulted the ED for traumatic brain injury (TBI) in 2022, their relationship with cognitive impairment, functional dependence, use of oral antiplatelet/anticoagulant drugs and complications. MATERIALS AND METHODS: Retrospective study conducted from 1 January to 31 December 2022. Demographic data were collected: age, sex, origin; cardiovascular risk factors; cognitive impairment using the Pfeiffer questionnaire; physical disability according to the Barthel Index; number of drugs; use of antiplatelet and oral anticoagulant (OAC); mechanism of fall; performance of cranial X-ray/CT, and presence of complications: intracranial haemorrhage (ICH), death...

BACKGROUND: The interest in re-introducing whole blood (WB) transfusion for the management of traumatic major haemorrhage is increasing. However, due to the current leucodepletion filters used in the UK a WB component was not readily available. Instead, an alternative but similar component, leucocyte depleted red cell and plasma (LD-RCP), which provided a unique experience in assessing the feasibility of a WB component was used whilst a WB component was being manufactured. STUDY DESIGN AND METHODS: Between November 2018 and October 2020, LD-RCP replaced RBC as standard of care for all trauma patients with major haemorrhage in London...

OBJECTIVE: To identify the characteristics and treatment approaches for patients with severe postpartum haemorrhage (SPPH) in various midwifery institutions in one district in Beijing, especially those without identifiable antenatal PPH high-risk factors, to improve regional SPPH rescue capacity. DESIGN: Retrospective cohort study. SETTING: This study was conducted at 9 tertiary-level hospitals and 10 secondary-level hospitals in Haidian district of Beijing from January 2019 to December 2022...

BACKGROUND: Violent interpersonal acts account for a large proportion of unnatural deaths in South Africa. A significant proportion of unnatural deaths are due to penetrating thoracic trauma and preventable haemorrhage. Current indications for emergent thoracotomy are unreliable. We propose the use of lactate, shock index (SI) and base deficit (BD) as a triage tool in patients with penetrating thoracic injuries to identify those requiring surgical intervention. METHODS: A review of the trauma registry of the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) was carried out between March 2011 and March 2016...

A 63-year-old male presented to our clinic with computed tomography data of a large tumor of the left adrenal gland. The formation is highly suspicious for malignancy with central necrosis and hemorrhage, and a total size of 197/183/201 mm. Due to elevated D-dimer values of 7.17 mg/l (reference range <0.5 mg/l), treatment with dabigatran etexilate 2x150 mg was prescribed following a cardiology consult. On the third day of therapy, the patient noticed a large swelling in the left abdominal flank, which caused discomfort...

BACKGROUND: Traumatic brain injuries account for up to 50% of trauma related deaths and if surgical intervention is indicated, consensus suggests a maximum of 4 hours to surgical decompression. The occurrence and outcomes of craniotomies performed by non-neurosurgeons in regional Queensland hospitals have never been reported previously in the literature. METHODS: A retrospective review was performed at all regional Queensland hospitals without an on-site neurosurgical service from January 2001 to December 2022 to identify patients undergoing emergency craniotomy...

BACKGROUND: Around one-fourth of maternal deaths worldwide are attributed to hemorrhage. One of the prevalent types of maternal hemorrhage is postpartum hemorrhage. In spite of this, there is very little data on postpartum hemorrhage. Thus, the intention of this study was to determine factors associated with postpartum hemorrhage among mothers who gave birth in the selected Southern Oromia hospitals in Ethiopia. METHODS: An institutional-based, unmatched case-control study was employed on a sample of 333 (83 cases and 250 controls) mothers who gave birth from March 1-30, 2021...

BACKGROUND: Major traumatic haemorrhage is potentially preventable with rapid haemorrhage control and improved resuscitation techniques. Although advances in prehospital trauma management, haemorrhage is still associated with high mortality. The aim of this study was to use a recent pragmatic transfusion-based definition of major bleeding to characterize patients at risk of major bleeding and associated outcomes in this cohort after trauma. METHODS: This was a retrospective cohort study including all trauma patients (n = 7020) admitted to a tertiary trauma center from January 2015 to June 2020...

Purpose : The most prominent risk factors for mortality after mild traumatic brain injury (TBI) have not been established. This study aimed to establish risk factors related to 90-day mortality after a traumatic event. Methods : A retrospective cohort study on adult patients entering the Emergency Department of the University Hospital of Trieste for mild TBI from 1 January 2020 to 31 December 2020 was conducted. Results : The final population was 1221 patients (median age of 78 years). The 90-day mortality rate was 7% (90 patients)...

OBJECTIVES: A 2021 safety alert restricted endovascular gelfoam use in Australia and resulted in an embargo on gelfoam sales to IR departments. This study aimed to show that gelfoam is safe in a population of trauma patients with pelvic injury, and discuss the basis of the recent controversies. METHODS: Retrospective cohort study between 1 January 2010 and 21 May 2021 of patients who underwent gelfoam embolisation for pelvic arterial haemorrhage. Primary outcome was the rate of adverse events related to intravascular gelfoam administration...

Diffuse axonal injury (DAI) is a severe and frequently life-altering form of traumatic brain injury that is brought on by forces of rapid acceleration as well as deceleration impacting the brain. DAI primarily stems from mechanical forces that lead to the widespread disruption of axons throughout the brain. Unlike focal injuries that affect a specific brain region, DAI manifests as multifocal axonal damage, often impairing vital neural connections. This injury occurs due to shear and tensile forces during traumatic events, such as car accidents, falls, and sports-related incidents...

OBJECTIVE: The objective of this study is to characterize bladder mucosal trauma associated with intermittent catheterization with conventional eyelet catheters (CECs) and to assess if a microhole zone catheter (MHZC) design concept reduces this adverse effect. MATERIALS AND METHODS: A porcine model was developed to reflect human catheterization and bladder drainage. Nine pigs were randomized for catheterization with CEC ( n  = 6) or MHZC ( n  = 3)...

Postpartum haemorrhage (PPH) is a significant cause of maternal mortality globally, necessitating prompt and efficient management. This review provides a comprehensive exploration of endovascular treatment dimensions for both primary and secondary PPH, with a focus on uterine atony, trauma, placenta accreta spectrum (PAS), and retained products of conception (RPOC). Primary PPH, occurring within 24 h, often results from uterine atony in 70% of causes, but also from trauma, or PAS. Uterine atony involves inadequate myometrial contraction, addressed through uterine massage, oxytocin, and, if needed, mechanical modalities like balloon tamponade...