BACKGROUND Most major abdominal vascular injuries are caused by penetrating injuries.A common iliac artery occlusion caused by blunt force trauma is rare,and very few cases have been reported.Because of this low incid...BACKGROUND Most major abdominal vascular injuries are caused by penetrating injuries.A common iliac artery occlusion caused by blunt force trauma is rare,and very few cases have been reported.Because of this low incidence,atypical symptoms,and frequent association with other severe injuries,the proper diagnosis tends to be missed or delayed.The gold standard for diagnosis is angiography,and treatment remains a challenge.CASE SUMMARY We report here the unusual case of a common iliac artery occlusion caused by blunt abdominal compressive trauma,with transection of the small intestine.At presentation,the patient(a 56-year-old man)complained of pain and numbness in the left lower extremity and severe pain in the whole abdomen.Physical examination showed total abdominal tenderness with evidence of peritoneal irritation.The left lower limb was pulseless and cold.Abdominal computed tomography examination revealed digestive tract perforation,and abdominal computed tomography angiography showed left common iliac artery occlusion.The patient was treated successfully by anastomosis of the intestine,percutaneous transluminal angioplasty,and stenting.The patient was followed for more than 11 mo after the operation and showed a good recovery.CONCLUSION Patients with abdominal trauma should be suspected of having major vascular injury.Individualized treatment strategies are needed for this condition.展开更多
Introduction: Traumatic diaphragmatic hernia is a rare condition in children complicating closed or penetrating trauma to the abdomen and thorax. We report the case of an 11-year-old girl with a traumatic diaphragmati...Introduction: Traumatic diaphragmatic hernia is a rare condition in children complicating closed or penetrating trauma to the abdomen and thorax. We report the case of an 11-year-old girl with a traumatic diaphragmatic hernia. Case Presentation: An 11-year-old girl was seen in the paediatric surgery department for a thoracolumbar spine deformity and intermittent chest pain. These symptoms occurred after a domestic accident involving a fall from a low wall onto the thoracolumbar spine 5 months previously. The diagnosis was suggested by the presence of a left hemithoracic hydroaera and confirmed by a thoraco-abdominal CT scan. Surgical exploration revealed a linear rupture of the entire left hemi-diaphragm with herniation of the stomach, small intestine, cecum, transverse colon and omentum. We performed a double-layer suture of the diaphragmatic rupture with a non-absorbable suture without edge rejuvenation after the reduction of the hernia. The outcome was favourable with normal postoperative radiographs at one year follow-up. Conclusion: Traumatic diaphragmatic hernia, although uncommon and difficult to diagnose, is a condition that is relatively easy to manage surgically, even if it is discovered late. In all cases of trauma to the thoracolumbar spine, regular follow-up and repeat X-rays are necessary if pain persists.展开更多
We report a case of a large plant foreign body in the orbit. A 30-year-old male presented to our hospital 6 h after a penetrating orbital injury in his left superior eyelid when he skidded from his motorcycle while ri...We report a case of a large plant foreign body in the orbit. A 30-year-old male presented to our hospital 6 h after a penetrating orbital injury in his left superior eyelid when he skidded from his motorcycle while riding. When the patient reported to us, he already had an inability to open his left eye and a continuous pain in the left orbit. On examination, there was a large plant foreign body penetrating the nasal orbit through the left upper eyelid. Orbital CT revealed a low density linear foreign body measuring 3.6 ×0.5 cm in the left orbit.An emergency operation was performed to remove the foreign body. The patient's visual acuity did not recover satisfactorily due to optic nerve injury.This case highlights the fact that careful surgical removal of foreign bodies is the treatment of choice and that all patients should receive post-operative antibiotic therapy because of the high incidence of secondary orbital infections. The final outcome and prognosis depend greatly upon the composition and location of the foreign body and whether there are serious complications. (Eye Science 2013;.28:44 - 47)展开更多
Scrotal trauma in motorcycle accidents (STMA) is a rare entity in the literature. In general, trauma to the genitals is not life-threatening. However, STMA can cause rupture of the testis with consequences that can le...Scrotal trauma in motorcycle accidents (STMA) is a rare entity in the literature. In general, trauma to the genitals is not life-threatening. However, STMA can cause rupture of the testis with consequences that can lead to alteration of sexuality and reproduction. We present an STMA case managed in a rural hospital where various types of injuries arise from motorcycle accidents. A 20-year-old man without any previous pathology presented in our hospital with a swollen painful scrotum. One week prior to presentation, the patient with a speeding motorbike drove over a speed bump, and the frame of his motorcycle broke into two halves, violently striking his genitals and causing scrotal trauma. After examination and investigation, patient has consented to scrotal exploration which was carried out. A partial left orchidectomy was performed and the right testicle was healthy. The evolution was favorable and the patient was discharged on the 5th postoperative day. Prognosis at 6 months was good. It is possible that genital trauma related to motorcycle accidents will become more frequent in the future. This underscores the importance of educating motorcyclists to respect the Highway Code;and making practitioners aware of the risk of serious injury in the event of acute scrotal trauma.展开更多
High-grade renal trauma rarely occurs due to low-velocity mechanisms. With its clinical presentation, delayed diagnosis rarely happens. We report the case of a 12-year-old girl diagnosed seven days post-trauma with gr...High-grade renal trauma rarely occurs due to low-velocity mechanisms. With its clinical presentation, delayed diagnosis rarely happens. We report the case of a 12-year-old girl diagnosed seven days post-trauma with grade IV renal trauma complicated with infected urinoma and bilateral lower polar vessels. She was non-operatively managed with ultrasound-guided percutaneous drainage of the urinoma, which resolved, and had unremarkable six months follow-up. We discuss the role of preexistent hydronephrosis in low-velocity impact, pitfalls of diagnosis in resource-constrained settings, and management of high-grade trauma.展开更多
A closed degloving injury, or Morel-Lavallee lesion, is the result of a severe, traumatic, shearing injury, causing separation of the skin and subcutaneous tissue from the underlying deep fascia. Though well described...A closed degloving injury, or Morel-Lavallee lesion, is the result of a severe, traumatic, shearing injury, causing separation of the skin and subcutaneous tissue from the underlying deep fascia. Though well described in the orthopedic trauma literature, this lesion is not well recognized by the general surgeon in the poly-trauma setting. We present a case of a 41 year old man who was referred to the general surgery service for a “back abscess”. Upon patient interview, history of a recent motor vehicle collision (MVC) was obtained, including a pelvic fracture. Imaging demonstrated a large Morel-Lavellee lesion extending from the pelvis into the lower back. Knowledge of this entity is crucial to avoid unnecessary procedures in the management of these patients.展开更多
<b><span>Introduction:</span></b><span> Maxillofacial injuries caused by motorcycle road accidents are serious and represent a real public health issue. They mainly affect young adul...<b><span>Introduction:</span></b><span> Maxillofacial injuries caused by motorcycle road accidents are serious and represent a real public health issue. They mainly affect young adult males. The objectives of this study were to determine the frequency of motorcycle road accidents, describe the socio-demographic characteristics of the injured, determine the degree of severity of motorcycle injuries compared to car injuries, and describe the therapeutic modalities.</span><span> </span><b><span>Materials and Method:</span></b><span> This study was a prospective case-control study carried out in the Department of Odontostomatology, Maxillofacial Surgery and Surgical Emergencies at the National Hospital of Donka. The data w</span><span>as</span><span> collected over a period of six months from January 1st to June 30th, 2017. All victims of road accidents by motorcycle (cases) or car (controls) that received care and post-surgical follow up were included.</span><span> </span><b><span>Results: </span></b><span>A total of 505 patients with maxillofacial injuries were reviewed during the period of the study.</span><span> </span><span>From the review, 205 (40.6%) motorcycle accidents were recorded as “cases” and 109 (21.58%) car accidents were classified as “controls” group. Men were the most affected in both groups, n = 254 (177 males in the case group and 77 in the control) (p = 0.01). There was a proportionate relationship between helmet use and death (p = 0.015). A motorcycle accident victim is more likely to develop a mandibular fracture (p = 0.029) and limb injury (p = 0.034) when compared to a car accident victim. However, there was no significant difference between cases and controls for head trauma (p = 0.4878), Facial Injury Severity Scale (FISS) (p = 0.130), and Glasgow score (p = 0.709).</span><span> </span><b><span>Conclusion:</span></b><span> Maxillofacial injuries caused by motorcycle accidents </span><span>are</span><span> increasing </span><span>in</span><span> Guinea. Young adult males have the highest incidence </span><span>of</span><span> motorcycle accidents. The death rate related to motorcycle road accidents is high, and mandatory use of a helmet for all drivers and passengers is recommended. These preventative actions could reduce the mortality and morbidity of motorcycle road accidents in Guinea.</span>展开更多
文摘BACKGROUND Most major abdominal vascular injuries are caused by penetrating injuries.A common iliac artery occlusion caused by blunt force trauma is rare,and very few cases have been reported.Because of this low incidence,atypical symptoms,and frequent association with other severe injuries,the proper diagnosis tends to be missed or delayed.The gold standard for diagnosis is angiography,and treatment remains a challenge.CASE SUMMARY We report here the unusual case of a common iliac artery occlusion caused by blunt abdominal compressive trauma,with transection of the small intestine.At presentation,the patient(a 56-year-old man)complained of pain and numbness in the left lower extremity and severe pain in the whole abdomen.Physical examination showed total abdominal tenderness with evidence of peritoneal irritation.The left lower limb was pulseless and cold.Abdominal computed tomography examination revealed digestive tract perforation,and abdominal computed tomography angiography showed left common iliac artery occlusion.The patient was treated successfully by anastomosis of the intestine,percutaneous transluminal angioplasty,and stenting.The patient was followed for more than 11 mo after the operation and showed a good recovery.CONCLUSION Patients with abdominal trauma should be suspected of having major vascular injury.Individualized treatment strategies are needed for this condition.
文摘Introduction: Traumatic diaphragmatic hernia is a rare condition in children complicating closed or penetrating trauma to the abdomen and thorax. We report the case of an 11-year-old girl with a traumatic diaphragmatic hernia. Case Presentation: An 11-year-old girl was seen in the paediatric surgery department for a thoracolumbar spine deformity and intermittent chest pain. These symptoms occurred after a domestic accident involving a fall from a low wall onto the thoracolumbar spine 5 months previously. The diagnosis was suggested by the presence of a left hemithoracic hydroaera and confirmed by a thoraco-abdominal CT scan. Surgical exploration revealed a linear rupture of the entire left hemi-diaphragm with herniation of the stomach, small intestine, cecum, transverse colon and omentum. We performed a double-layer suture of the diaphragmatic rupture with a non-absorbable suture without edge rejuvenation after the reduction of the hernia. The outcome was favourable with normal postoperative radiographs at one year follow-up. Conclusion: Traumatic diaphragmatic hernia, although uncommon and difficult to diagnose, is a condition that is relatively easy to manage surgically, even if it is discovered late. In all cases of trauma to the thoracolumbar spine, regular follow-up and repeat X-rays are necessary if pain persists.
文摘We report a case of a large plant foreign body in the orbit. A 30-year-old male presented to our hospital 6 h after a penetrating orbital injury in his left superior eyelid when he skidded from his motorcycle while riding. When the patient reported to us, he already had an inability to open his left eye and a continuous pain in the left orbit. On examination, there was a large plant foreign body penetrating the nasal orbit through the left upper eyelid. Orbital CT revealed a low density linear foreign body measuring 3.6 ×0.5 cm in the left orbit.An emergency operation was performed to remove the foreign body. The patient's visual acuity did not recover satisfactorily due to optic nerve injury.This case highlights the fact that careful surgical removal of foreign bodies is the treatment of choice and that all patients should receive post-operative antibiotic therapy because of the high incidence of secondary orbital infections. The final outcome and prognosis depend greatly upon the composition and location of the foreign body and whether there are serious complications. (Eye Science 2013;.28:44 - 47)
文摘Scrotal trauma in motorcycle accidents (STMA) is a rare entity in the literature. In general, trauma to the genitals is not life-threatening. However, STMA can cause rupture of the testis with consequences that can lead to alteration of sexuality and reproduction. We present an STMA case managed in a rural hospital where various types of injuries arise from motorcycle accidents. A 20-year-old man without any previous pathology presented in our hospital with a swollen painful scrotum. One week prior to presentation, the patient with a speeding motorbike drove over a speed bump, and the frame of his motorcycle broke into two halves, violently striking his genitals and causing scrotal trauma. After examination and investigation, patient has consented to scrotal exploration which was carried out. A partial left orchidectomy was performed and the right testicle was healthy. The evolution was favorable and the patient was discharged on the 5th postoperative day. Prognosis at 6 months was good. It is possible that genital trauma related to motorcycle accidents will become more frequent in the future. This underscores the importance of educating motorcyclists to respect the Highway Code;and making practitioners aware of the risk of serious injury in the event of acute scrotal trauma.
文摘High-grade renal trauma rarely occurs due to low-velocity mechanisms. With its clinical presentation, delayed diagnosis rarely happens. We report the case of a 12-year-old girl diagnosed seven days post-trauma with grade IV renal trauma complicated with infected urinoma and bilateral lower polar vessels. She was non-operatively managed with ultrasound-guided percutaneous drainage of the urinoma, which resolved, and had unremarkable six months follow-up. We discuss the role of preexistent hydronephrosis in low-velocity impact, pitfalls of diagnosis in resource-constrained settings, and management of high-grade trauma.
文摘A closed degloving injury, or Morel-Lavallee lesion, is the result of a severe, traumatic, shearing injury, causing separation of the skin and subcutaneous tissue from the underlying deep fascia. Though well described in the orthopedic trauma literature, this lesion is not well recognized by the general surgeon in the poly-trauma setting. We present a case of a 41 year old man who was referred to the general surgery service for a “back abscess”. Upon patient interview, history of a recent motor vehicle collision (MVC) was obtained, including a pelvic fracture. Imaging demonstrated a large Morel-Lavellee lesion extending from the pelvis into the lower back. Knowledge of this entity is crucial to avoid unnecessary procedures in the management of these patients.
文摘<b><span>Introduction:</span></b><span> Maxillofacial injuries caused by motorcycle road accidents are serious and represent a real public health issue. They mainly affect young adult males. The objectives of this study were to determine the frequency of motorcycle road accidents, describe the socio-demographic characteristics of the injured, determine the degree of severity of motorcycle injuries compared to car injuries, and describe the therapeutic modalities.</span><span> </span><b><span>Materials and Method:</span></b><span> This study was a prospective case-control study carried out in the Department of Odontostomatology, Maxillofacial Surgery and Surgical Emergencies at the National Hospital of Donka. The data w</span><span>as</span><span> collected over a period of six months from January 1st to June 30th, 2017. All victims of road accidents by motorcycle (cases) or car (controls) that received care and post-surgical follow up were included.</span><span> </span><b><span>Results: </span></b><span>A total of 505 patients with maxillofacial injuries were reviewed during the period of the study.</span><span> </span><span>From the review, 205 (40.6%) motorcycle accidents were recorded as “cases” and 109 (21.58%) car accidents were classified as “controls” group. Men were the most affected in both groups, n = 254 (177 males in the case group and 77 in the control) (p = 0.01). There was a proportionate relationship between helmet use and death (p = 0.015). A motorcycle accident victim is more likely to develop a mandibular fracture (p = 0.029) and limb injury (p = 0.034) when compared to a car accident victim. However, there was no significant difference between cases and controls for head trauma (p = 0.4878), Facial Injury Severity Scale (FISS) (p = 0.130), and Glasgow score (p = 0.709).</span><span> </span><b><span>Conclusion:</span></b><span> Maxillofacial injuries caused by motorcycle accidents </span><span>are</span><span> increasing </span><span>in</span><span> Guinea. Young adult males have the highest incidence </span><span>of</span><span> motorcycle accidents. The death rate related to motorcycle road accidents is high, and mandatory use of a helmet for all drivers and passengers is recommended. These preventative actions could reduce the mortality and morbidity of motorcycle road accidents in Guinea.</span>
