Shrapnel injuries of the superior vena cava (SVC) are extremely rare and highly lethal. The true incidence is not known since many patients succumb shortly after injury. The high fatality is due to difficulty in diagn...Shrapnel injuries of the superior vena cava (SVC) are extremely rare and highly lethal. The true incidence is not known since many patients succumb shortly after injury. The high fatality is due to difficulty in diagnosis, technical problems with repair and consequences of SVC clamping. Literature review revealed no shrapnel SVC injury reported before. This is a report of 30-year-old man from Kirkuk, Iraq, a victim of terroristic attack who was admitted to Sulaimania Teaching Hospital (STH) on June 2007 with shock, massive right-side haemothorax and a wound at base of neck following a shrapnel injury. Emergency right thoracotomy revealed clotted haemothorax and big shrapnel partly sealing a tear in SVC just above the entrance of the azygos vein. Severe bleeding ensued after extraction of the shrapnel. Attempts to control the hemorrhage and repair of the injury failed and unfortunately, the patient expired in the theatre. Though there is no pathognomonic sign of SVC injury, it should be suspected in patients presenting with shock and haemothorax. Successful repair is achievable with early diagnosis, aggressive resuscitation, early exploration, optimum operating conditions and special measures such as auto-transfusion and cardiopulmonary bypass.展开更多
It is important to minimize the destruction of defense works when blasted. In our opinion, information in the available literature is very deficient. We now present our research results on better and simpler formulas ...It is important to minimize the destruction of defense works when blasted. In our opinion, information in the available literature is very deficient. We now present our research results on better and simpler formulas for calculating the velocities and displacements of shrapnel and a shock wave; these formulas are indispensable for understanding the destruction of blast. Formulas now available in China are too complicated. In this paper, we derive Equation （ 13 ） as the formula for calculating the velocity of shrapnel and Equation （ 18 ） as that for calculating the velocity of a shock wave. We used the test data of Denver Research Institute, as reported in Reference 4, as numerical example and found that our Equations （13） and （18） give calculated results that agree well with their test data in two respects： （ 1 ） both test data and our calculations show that at first a shock wave is ahead of shrapnel, then their displacements are equal, and finaUy shrapnel is ahead of the shock wave; （2） when the displacements of shrapnel and shock wave are equal, the time is 0. 34 s according to test data and 0. 31 s according to our calculations.展开更多
Injuries deeper than the platysma are considered as penetrating neck injuries,constituting approximately 5%-10%of all trauma.Many vital organs are at risk from a penetrating neck injury.These injuries in zone 1 have t...Injuries deeper than the platysma are considered as penetrating neck injuries,constituting approximately 5%-10%of all trauma.Many vital organs are at risk from a penetrating neck injury.These injuries in zone 1 have the highest mortality,because the injuries are close to the vital organs and difficult to access surgically.A 41-year-old male,a car mechanic by profession,presented to the emergency department with a penetrating neck injury on the right side.CT scan demonstrated a metallic foreign body in zone 1 between the right internal jugular vein and the common carotid artery.The patient was asymptomatic,and the foreign body was removed surgically.This case shows a rare presentation of a penetrating neck injury with a foreign body located in zone 1,where no vital internal structure was injured.As of now,no previous case report has been identified on such presentation.Thus,it will provide a valuable addition to the pre-existing literature.展开更多
文摘Shrapnel injuries of the superior vena cava (SVC) are extremely rare and highly lethal. The true incidence is not known since many patients succumb shortly after injury. The high fatality is due to difficulty in diagnosis, technical problems with repair and consequences of SVC clamping. Literature review revealed no shrapnel SVC injury reported before. This is a report of 30-year-old man from Kirkuk, Iraq, a victim of terroristic attack who was admitted to Sulaimania Teaching Hospital (STH) on June 2007 with shock, massive right-side haemothorax and a wound at base of neck following a shrapnel injury. Emergency right thoracotomy revealed clotted haemothorax and big shrapnel partly sealing a tear in SVC just above the entrance of the azygos vein. Severe bleeding ensued after extraction of the shrapnel. Attempts to control the hemorrhage and repair of the injury failed and unfortunately, the patient expired in the theatre. Though there is no pathognomonic sign of SVC injury, it should be suspected in patients presenting with shock and haemothorax. Successful repair is achievable with early diagnosis, aggressive resuscitation, early exploration, optimum operating conditions and special measures such as auto-transfusion and cardiopulmonary bypass.
文摘It is important to minimize the destruction of defense works when blasted. In our opinion, information in the available literature is very deficient. We now present our research results on better and simpler formulas for calculating the velocities and displacements of shrapnel and a shock wave; these formulas are indispensable for understanding the destruction of blast. Formulas now available in China are too complicated. In this paper, we derive Equation （ 13 ） as the formula for calculating the velocity of shrapnel and Equation （ 18 ） as that for calculating the velocity of a shock wave. We used the test data of Denver Research Institute, as reported in Reference 4, as numerical example and found that our Equations （13） and （18） give calculated results that agree well with their test data in two respects： （ 1 ） both test data and our calculations show that at first a shock wave is ahead of shrapnel, then their displacements are equal, and finaUy shrapnel is ahead of the shock wave; （2） when the displacements of shrapnel and shock wave are equal, the time is 0. 34 s according to test data and 0. 31 s according to our calculations.
文摘Injuries deeper than the platysma are considered as penetrating neck injuries,constituting approximately 5%-10%of all trauma.Many vital organs are at risk from a penetrating neck injury.These injuries in zone 1 have the highest mortality,because the injuries are close to the vital organs and difficult to access surgically.A 41-year-old male,a car mechanic by profession,presented to the emergency department with a penetrating neck injury on the right side.CT scan demonstrated a metallic foreign body in zone 1 between the right internal jugular vein and the common carotid artery.The patient was asymptomatic,and the foreign body was removed surgically.This case shows a rare presentation of a penetrating neck injury with a foreign body located in zone 1,where no vital internal structure was injured.As of now,no previous case report has been identified on such presentation.Thus,it will provide a valuable addition to the pre-existing literature.
