WorldWideScience

Sample records for blunt traumatic pericardial

  1. Blunt traumatic pericardial rupture and cardiac herniation with a penetrating twist: two case reports

    Directory of Open Access Journals (Sweden)

    Galloway Robert

    2009-12-01

    Full Text Available Abstract Background Blunt Traumatic Pericardial Rupture (BTPR with resulting cardiac herniation following chest trauma is an unusual and often fatal condition. Although there has been a multitude of case reports of this condition in past literature, the recurring theme is that of a missed injury. Its occurrence in severe blunt trauma is in the order of 0.4%. It is an injury that frequently results in pre/early hospital death and diagnosis at autopsy, probably owing to a combination of diagnostic difficulties, lack of familiarity and associated polytrauma. Of the patients who survive to hospital attendance, the mortality rate is in the order of 57-64%. Methods We present two survivors of BTPR and cardiac herniation, one with a delayed penetrating cardiac injury secondary to rib fractures. With these two cases and literature review, we hope to provide a greater awareness of this injury Conclusion BTPR and cardiac herniation is a complex and often fatal injury that usually presents under the umbrella of polytrauma. Clinicians must maintain a high index of suspicion for BTPR but, even then, the diagnosis is fraught with difficulty. In blunt chest trauma, patients should be considered high risk for BTPR when presenting with: Cardiovascular instability with no obvious cause Prominent or displaced cardiac silhouette and asymmetrical large volume pneumopericardium Potentially, with increasing awareness of the injury and improved use and availability of imaging modalities, the survival rates will improve and cardiac Herniation could even be considered the 5th H of reversible causes of blunt traumatic PEA arrest.

  2. Blunt traumatic pericardial rupture.

    OpenAIRE

    Levine, A. J.; Collins, F J

    1995-01-01

    A 28-year-old man presented with left chest, head and limb injuries following a road traffic accident (RTA). Increasing haemodynamic instability necessitated an emergency left thoracotomy at which a complete rupture of the pericardium and herniation of the heart was found. After repair, the patient made an uneventful post-operative recovery. The aetiology, investigation and management of this rare injury is discussed.

  3. Blunt traumatic diaphragmatic rupture

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Nogueira

    2011-09-01

    Full Text Available Traumatic injury of the diaphragm ranges from 0.6 to 1.2% and rise up to 5%among patients who were victims of blunt trauma and underwent laparotomy.Clinical suspicion associated with radiological assessment contributes to earlydiagnosis. Isolated diaphragmatic injury has a good prognosis. Generallyworse outcomes are associated with other trauma injuries. Bilateral andright diaphragmatic lesions have worse prognosis. Multi detector computed tomography (MDCT scan of the chest and abdomen provides better diagnosticaccuracy using the possibility of image multiplanar reconstruction. Surgicalrepair via laparotomy and/ or thoracotomy in the acute phase of the injury hasa better outcome and avoids chronic complications of diaphragmatic hernia.The authors present the case of a young male patient, victim of blunt abdominaltrauma due to motor vehicle accident with rupture of the diaphragm, spleenand kidney injuries. The diagnosis was made by computed tomography of thethorax and abdomen and was confirmed during laparotomy.

  4. Right Atrium Laceration with Pericardial Tamponade: A Rare Presentation of Blunt Cardiac Trauma

    Directory of Open Access Journals (Sweden)

    Hamid Hoseinikhah

    2015-11-01

    Full Text Available Cardiac laceration from blunt thoracic trauma is not a common presentation. The rate of mortality due to this injury is very high since it is not diagnosed and treated immediately. In this study, we present the case of a 65-year-old man with blunt cardiac trauma, causing right atrial rupture and pericardial tamponade. Successful management of this patient was firstly done with initial pericardiocentesis. Then, the patient was immediately transferred to the operating room for tamponade relief and cardiac wall repair. We recommend that cardiac surgeon have  an important suspicious for cardiac involvement in Blunt chest wall trauma

  5. Blunt traumatic cardiac rupture. A 5-year experience.

    Science.gov (United States)

    Brathwaite, C E; Rodriguez, A; Turney, S Z; Dunham, C M; Cowley, R

    1990-12-01

    Blunt traumatic cardiac rupture is associated with a high rate of mortality. A review of the computerized trauma registry (1983 to 1988) identified 32 patients with this injury (ages 19 to 65 years; mean age, 39.5 years; 21 men and 11 women). Twenty-one patients (65.6%) were injured in vehicular crashes, 3 (9.4%) in pedestrian accidents, 3 (9.4%) in motorcycle accidents; 3 (9.4%) sustained crush injury; 1 (3.1%) was injured by a fall; and 1 (3.1%) was kicked in the chest by a horse. Anatomic injuries included right atrial rupture (13[40.6%]), left atrial rupture (8 [25%]), right ventricular rupture (10[31.3%]), left ventricular rupture (4[12.5%]), and rupture of two cardiac chambers (3 [9.4%]). Diagnosis was made by thoracotomy in all 20 patients presenting in cardiac arrest. In the remaining 12 patients, the diagnosis was established in seven by emergency left anterolateral thoracotomy and in five by subxyphoid pericardial window. Seven of these 12 patients (58.3%) had clinical cardiac tamponade and significant upper torso cyanosis. The mean Injury Severity Score (ISS), Trauma Score (TS), and Glasgow Coma Scale (GCS) score were 33.8, 13.2, and 14.3, respectively, among survivors and 51.5, 8.3, and 7.0 for nonsurvivors. The overall mortality rate was 81.3% (26 of 32 patients), the only survivors being those presenting with vital signs (6 of 12 patients [50%]). All patients with rupture of two cardiac chambers or with ventricular rupture died. The mortality rate from myocardial rupture is very high. Rapid prehospital transportation, a high index of suspicion, and prompt surgical intervention contribute to survival in these patients. PMID:2256761

  6. Blunt traumatic rupture of the heart and pericardium: a ten-year experience (1979-1989).

    Science.gov (United States)

    Fulda, G; Brathwaite, C E; Rodriguez, A; Turney, S Z; Dunham, C M; Cowley, R A

    1991-02-01

    Blunt traumatic rupture of the heart and pericardium, rarely diagnosed preoperatively, carries a high mortality rate. From 1979 to 1989, more than 20,000 patients were admitted to a Level I trauma center. A retrospective review identified 59 patients requiring emergency surgery for this condition. Injuries resulted from vehicular accidents (68%), motorcycle crashes (10%), pedestrians being struck by vehicles (7%), falls (5%), crushing (7%), and being struck by a horse (2%) or crane (2%). Seventeen patients (29%) had isolated rupture of the pericardium; 37 (63%) had ruptures of one or more cardiac chambers. All patients had signs of life at the scene or during transportation, but only 29 (49%) had vital signs on admission: 15 with chamber injury, 12 with pericardial rupture, and two with combined injuries. Diagnosis was established by emergency thoracotomy in the 30 patients who arrived in cardiac arrest. In the remaining 29 patients, diagnosis was made by urgent thoracotomy (41%), by subxiphoid pericardial window (34%), during laparotomy (21%), or by chest radiography (3%). The overall mortality rate was 76% (45 patients), but only 52% for those with vital signs on admission. Rapid transportation and expeditious surgical treatment can save many patients with these injuries. PMID:1994075

  7. Blunt force thoracic trauma: a case study of pericardial rupture and associated cardiac herniation.

    Science.gov (United States)

    Glotzer, O S; Bhakta, A; Fabian, T

    2014-01-01

    Pericardial rupture, with associated cardiac herniation, is generally fatal. Diagnosis is difficult and frequently missed due to the subtlety of identifying characteristics. We report a case of a left sided pericardial rupture and cardiac herniation resulting from a high speed motorcycle collision. This report describes the course of treatment from the emergent admission to the diagnosis of the pericardial tear to retrospective CT analysis and rupture identification. In addition the difficulties of initial diagnosis, key symptoms, and identification of CT images are presented and discussed. PMID:25184070

  8. Endovascular treatment of blunt traumatic thoracic aortic injury.

    Science.gov (United States)

    Nicolaou, Georghios

    2009-06-01

    Blunt traumatic thoracic aortic injury (BTTAI) is a lethal injury associated with a prehospital mortality of 80% to 90%. Patients arriving in the emergency room and considered appropriate to undergo emergency open surgical repair still have a mortality rate of 15% to 30% because of severe associated injuries. Conventional open surgical repair requires a left thoracotomy, single lung ventilation, aortic-cross clamping and unclamping, with or without the adjunct use of partial or full cardiopulmonary bypass and systemic heparinization. All this leads to significant physiological stress and surgical trauma resulting in perioperative complications such as major blood loss, coagulopathy, myocardial infarction, stroke, respiratory failure, renal failure, bowel infarction, and paraplegia. Despite advances in anesthesia, critical care medicine, and surgical techniques, a recent meta-analysis showed no definite improvement in operative mortality over the past decade, following open surgical repair in patients with BTTAI. Endovascular repair of BTTAI does not require a thoracotomy, single lung ventilation, aorticcross clamping and unclamping, or systemic heparinization. As a result, endovascular repair of BTTAI has emerged as an effective, minimally invasive treatment alternative, especially in patients with severe concomitant injuries, which may be prohibitive to open surgical repair. Recent published studies have shown that endovascular repair of BTTAI is associated with lower morbidity, mortality, stroke, and paraplegia/paraparesis rates, when compared with open surgical repair of BTTAI. PMID:19617250

  9. Traumatic Aniridia Following a Blunt Ocular Trauma in a Pseudophakic Patient

    Directory of Open Access Journals (Sweden)

    Baran Gencer

    2014-01-01

    Full Text Available Blunt ocular traumas cause serious ocular problems in the anterior and posterior segments of the eye and even may result in globe perforation. In the literature, some cases have been reported with aniridia by traumatic iris expulsion and preserved intraocular lens after blunt trauma in pseudophakic eyes that had undergone cataract surgery with phacoemulsification. In this case, phacoemulsification was performed four months before a blunt trauma to the same eye, intraocular lens remained centralized although traumatic aniridia and partial zonulolysis occurred. This is the first case of traumatic aniridia in a pseudophakic eye in our country, and we aimed to present the possibility of relative protective effects of small cataract incisions after blunt trauma. (Turk J Ophthalmol 2014; 44: 80-2

  10. Traumatic Abdominal Wall Hernia After a Blunt Trauma: A Case Report

    Directory of Open Access Journals (Sweden)

    Ersin Dumlu

    2014-06-01

    Full Text Available Traumatic abdominal wall hernia is a rare result of blunt abdominal traumas in adults. Altough the detection of the injuries of the abdominal organs is the priority in blunt traumas, abdominal wall defect may also occur in these patients. These hernias can go undetected due to preservation of the skin overlying the hernia defect. Traumatic abdominal wall hernias can have high morbidity and mortality rates due to incarceration and perforation of tubular hollow organs, especially if there is any delay. The possibility of traumatic hernia should always be considered in cases with serious blunt trauma. Computed Tomography (CT scan examinations should be performed routinely due to their high diagnostic value if trumatic hernia is suspected. In this report, a traumatic abdominal wall hernia patient who was treated by surgery has been presented with the review of the current literature.

  11. [Blunt traumatic rupture of the right ventricle, with intrapericardial rupture of the diaphragm. Successful surgical repair (author's transl)].

    Science.gov (United States)

    Le Treut, Y P; Herve, L; Boutboul, R; Cardon, J M; Bricot, R

    1980-12-01

    The authors report a case of blunt traumatic rupture of the right ventricle, diagnosed during a laparotomy. Similar cases were seldom met: too short a time of spontaneous survival, and difficult challenging diagnosis explain it. PMID:7462357

  12. Traumatic ventricular septal defect in a 4-year-old boy after blunt chest injury

    Directory of Open Access Journals (Sweden)

    Yun Mi Kim

    2011-02-01

    Full Text Available Traumatic ventricular septal defect (VSD resulting from blunt chest injury is a very rare event. The mechanisms of traumatic VSD have been of little concern to dateuntil now, but two dominant theories have been described. In one, the rupture occurs due to acute compression of the heart; in the other, it is due to myocardial infarction of the septum. The clinical symptoms and timing of presentation are variable, so appropriate diagnosis can be difficult or delayed. Closure of traumatic VSD has been based on a combination of heart failure symptoms, hemodynamics, and defect size. Here, we present a case of a 4-year-old boy who presented with a traumatic VSD following a car accident. He showed normal cardiac structure at the time of injury, but after 8 days, his repeated echocardiography revealed a VSD. He was successfully treated by surgical closure of the VSD, and has been doing well up to the present. This report suggests that the clinician should pay great close attention to the patients injured by blunt chest trauma, keeping in mind the possibility of cardiac injury.

  13. Traumatic diaphragmatic rupture with combined thoracoabdominal injuries: Difference between penetrating and blunt injuries

    Directory of Open Access Journals (Sweden)

    Gao Jinmou

    2015-07-01

    Full Text Available Purpose: Traumatic diaphragmatic rupture (TDR needs early diagnosis and operation. However, the early diagnosis is usually difficult, especially in the patients without diaphragmatic hernia. The objective of this study was to explore the early diagnosis and treatment of TDR. Methods: Data of 256 patients with TDR treated in our department between 1994 and 2013 were analyzed retrospectively regarding to the diagnostic methods, percentage of preoperative judgment, incidence of diaphragmatic hernia, surgical procedures and outcome, etc. Two groups were set up according to the mechanism of injury (blunt or penetrating. Results: Of 256 patients with a mean age of 32.4 years (9e84, 218 were male. The average ISS was 26.9 (13e66; and shock rate was 62.9%. There were 104 blunt injuries and 152 penetrating injuries. Preoperatively diagnostic rate was 90.4% in blunt injuries and 80.3% in penetrating, respectively, P < 0.05. The incidence of diaphragmatic hernia was 94.2% in blunt and 15.1% in penetrating respectively, P < 0.005. Thoracotomy was performed in 62 cases, laparotomy in 153, thoracotomy plus laparotomy in 29, and combined thoraco-laparotomy in 12. Overall mortality rate was 12.5% with the average ISS of 41.8; and it was 21.2% in blunt injuries and 6.6% in penetrating, respectively, P < 0.005. The main causes of death were hemorrhage and sepsis. Conclusions: Diagnosis of blunt TDR can be easily obtained by radiograph or helical CT scan signs of diaphragmatic hernia. For penetrating TDR without hernia, “offside sign” is helpful as initial assessment. CT scan with coronal/sagittal reconstruction is an accurate technique for diagnosis. All TDR require operation. Penetrating injury has a relatively better prognosis.

  14. Endovascular Treatment of Blunt Traumatic Abdominal Aortic Occlusion With Kissing Stent Placement

    International Nuclear Information System (INIS)

    Blunt traumatic abdominal aortic dissection is extremely rare and potentially deadly. We present the case of a 62-year-old man involved in a frontal car crash. After emergency undergoing laparotomy for bowel injuries, he was referred to our hospital due to acute ischemia of bilateral lower extremities on day 3 after the trauma. Computed tomography and aortography showed an aortobiiliac dissection with complete occlusion. This injury was successfully treated by endovascular treatment with “kissing”-technique stent placement, which appears to be a safe, effective, and minimally invasive treatment.

  15. Endovascular Treatment of Blunt Traumatic Abdominal Aortic Occlusion With Kissing Stent Placement

    Energy Technology Data Exchange (ETDEWEB)

    Idoguchi, Koji, E-mail: idoguchi@ares.eonet.ne.jp; Yamaguchi, Masato; Okada, Takuya [Kobe University Hospital, Department of Radiology and Center for Endovascular Therapy (Japan); Nomura, Yoshikatsu [Kobe University Hospital, Department of Cardiovascular Surgery (Japan); Sugimura, Kazuro [Kobe University Hospital, Department of Radiology and Center for Endovascular Therapy (Japan); Okita, Yutaka [Kobe University Hospital, Department of Cardiovascular Surgery (Japan); Sugimoto, Koji [Kobe University Hospital, Department of Radiology and Center for Endovascular Therapy (Japan)

    2012-10-15

    Blunt traumatic abdominal aortic dissection is extremely rare and potentially deadly. We present the case of a 62-year-old man involved in a frontal car crash. After emergency undergoing laparotomy for bowel injuries, he was referred to our hospital due to acute ischemia of bilateral lower extremities on day 3 after the trauma. Computed tomography and aortography showed an aortobiiliac dissection with complete occlusion. This injury was successfully treated by endovascular treatment with 'kissing'-technique stent placement, which appears to be a safe, effective, and minimally invasive treatment.

  16. Blunt abdominal trauma with handlebar injury: A rare cause of traumatic amputation of the appendix associated with acute appendicitis

    Directory of Open Access Journals (Sweden)

    Amanda Jensen

    2016-04-01

    Full Text Available We describe traumatic appendicitis in a 7-year-old boy who presented after sustaining blunt abdominal trauma to his right lower abdomen secondary to bicycle handlebar injury. With diffuse abdominal pain following injury, he was admitted for observation. Computed axial tomography (CT obtained at an outside hospital demonstrated moderate stranding of the abdomen in the right lower quadrant. The CT was non-contrasted and therefore significant appendiceal distention could not be confirmed. However, there was a calcified structure in the right pelvis with trace amount of free fluid. Patient was observed with conservative management and over the course of 15 h his abdominal pain continued to intensify. With his worsening symptoms, we elected to take him for diagnostic laparoscopy. In the operating room we found an inflamed traumatically amputated appendix with the mesoappendix intact. We therefore proceeded with laparoscopic appendectomy. Pathology demonstrated acute appendicitis with fecalith. It was unclear as to whether the patient's appendicitis and perforation were secondary to fecalith obstruction, his blunt abdominal trauma or if they concurrently caused his appendicitis. Acute appendicitis is a common acute surgical condition in the pediatric population and continues to be a rare and unique cause of operative intervention in the trauma population.

  17. The influence of potentially traumatic household characteristics on blunt use among Black youth.

    Science.gov (United States)

    Montgomery, LaTrice; Marinos, Dy'an

    2016-01-01

    The residential status of mothers and fathers in the household has been shown to influence drug use and other health outcomes among adolescents. However, no studies have examined if these household characteristics influence blunt use (marijuana mixed with or replacing tobacco in cigar paper), specifically among Black adolescents. Using data from the 2012 National Survey on Drug Use and Health, this study was designed to examine the relationship between household characteristics (non-residential mother vs. residential mother and non-residential father vs. residential father) and blunt use among Black male and female adolescents. Findings revealed that Black males with non-residential fathers were more likely to have smoked blunts in their lifetime than Black males with residential fathers, illustrating the importance of fathers in the lives of Black males. PMID:26939840

  18. Pericardial effusion

    Directory of Open Access Journals (Sweden)

    Shah Lilam

    1979-01-01

    Full Text Available Detection of pericardial fluid by non-invasive ultrasonic techni-que is reported in a case of myxedema. Mediastinal swing and pseudo mitral valve prolapse are demonstrated. Equally increased thickness of the interventricular septum and left ventricular poste-rior wall may be due to myxedematous infiltrative changes.

  19. Blunt Traumatic Aortic Injury of Right Aortic Arch in a Patient with an Aberrant Left Subclavian Artery

    Science.gov (United States)

    Yeo, Daryl Li-Tian; Haider, Sajjad; Zhen, Claire Alexandra Chew

    2015-01-01

    Right-sided aortic arch (RAA) is a rare congenital developmental variant present in about 0.1 percent of the population. This anatomical anomaly is commonly associated with congenital heart disease and complications from compression of mediastinal structures. However, it is unknown if patients are at a higher risk of blunt thoracic aortic injury (BTAI). We report a case of a 20-year-old man admitted to the hospital after being hit by an automobile. Computed tomographic scan revealed an RAA with an aberrant left subclavian artery originating from a Kommerell’s diverticulum. A pseudo-aneurysm was also seen along the aortic arch. A diagnosis of blunt traumatic aortic injury was made. The patient was successfully treated with a 26mm Vascutek hybrid stentgraft using the frozen elephant trunk technique. A literature review of the pathophysiology of BTAI was performed to investigate if patients with right-sided aortic arch are at a higher risk of suffering from BTAI. Results from the review suggest that although theoretically there may be a higher risk of BTAI in RAA patients, the rarity of this condition has prevented large studies to be conducted. Previously reported cases of BTAI in RAA have highlighted the possibility that the aortic isthmus may be anatomically weak and therefore prone to injury. We have explored this possibility by reviewing current literature of the embryological origins of the aortic arch and descending aorta. PMID:25745378

  20. Blunt cardiac injury: case report of salvaged traumatic right atrial rupture.

    Science.gov (United States)

    Al Ayyan, Muna; Aziz, Tanim; El Sherif, Amgad; Bekdache, Omar

    2016-11-01

    The incidence of cardiac rupture following blunt trauma is rare, occurring in 0.3%-0.5% of all blunt trauma patients. It can be fatal at the trauma scene, and is frequently missed in the emergency room setting. The severity of a cardiac trauma is based on the mechanism and degree of the force applied. The objective of this study was to report the case of a 32-year-old male patient who was involved in a motor vehicle collision and presented to the emergency room with signs of hypovolemic shock. The patient was found to have severe chest trauma associated with massive hemothorax requiring immediate intervention. The patient had an emergent thoracotomy revealing a right atrial injury. Repair of the atrial injury reversed the state of shock. The patient was discharged after 35 days of hospitalization in good condition. PMID:27054650

  1. Co-existence of a rare dyspnea with pericardial diaphragmatic rupture and pericardial rupture: a case report

    OpenAIRE

    Öz, Necdet; Kargı, Ahmet Bülent; Zeybek, Arife

    2015-01-01

    Pericardial-diaphragmatic rupture is a rare condition which occurs after blunt trauma and involves the herniation of abdominal organs into the pericardium. A 77-year-old female patient presenting with complaints of palpitation and difficulty in breathing was admitted to the emergency room. Left lateral thoracotomy revealed the herniation of abdominal organs into the thorax. A pericardial-diaphragmatic rupture and a pericardial rupture were found to co-exist. The diaphragm and the pericardium ...

  2. Traumatic asphyxia due to blunt chest trauma: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Sertaridou Eleni

    2012-08-01

    Full Text Available Abstract Introduction Crush asphyxia is different from positional asphyxia, as respiratory compromise in the latter is caused by splinting of the chest and/or diaphragm, thus preventing normal chest expansion. There are only a few cases or small case series of crush asphyxia in the literature, reporting usually poor outcomes. Case presentation We present the case of a 44-year-old Caucasian man who developed traumatic asphyxia with severe thoracic injury and mild brain edema after being crushed under heavy auto vehicle mechanical parts. He remained unconscious for an unknown time. The treatment included oropharyngeal intubation and mechanical ventilation, bilateral chest tube thoracostomies, treatment of brain edema and other supportive measures. Our patient’s outcome was good. Traumatic asphyxia is generally under-reported and most authors apply supportive measures, while the final outcome seems to be dependent on the length of time of the chest compression and on the associated injuries. Conclusion Treatment for traumatic asphyxia is mainly supportive with special attention to the re-establishment of adequate oxygenation and perfusion; treatment of the concomitant injuries might also affect the final outcome.

  3. Pericardial Fluid Analysis

    Science.gov (United States)

    ... Home Visit Global Sites Search Help? Pericardial Fluid Analysis Share this page: Was this page helpful? Formal name: Pericardial Fluid Analysis Related tests: Pleural Fluid Analysis , Peritoneal Fluid Analysis , ...

  4. Co-existence of a rare dyspnea with pericardial diaphragmatic rupture and pericardial rupture: a case report.

    Science.gov (United States)

    Öz, Necdet; Kargı, Ahmet Bülent; Zeybek, Arife

    2015-06-01

    Pericardial-diaphragmatic rupture is a rare condition which occurs after blunt trauma and involves the herniation of abdominal organs into the pericardium. A 77-year-old female patient presenting with complaints of palpitation and difficulty in breathing was admitted to the emergency room. Left lateral thoracotomy revealed the herniation of abdominal organs into the thorax. A pericardial-diaphragmatic rupture and a pericardial rupture were found to co-exist. The diaphragm and the pericardium were repaired primarily. The case is presented here because herniation of abdominal organs into the pleural cavity through the pericardium is a rare condition. PMID:26336505

  5. Efficiency Analysis of Direct Video-Assisted Thoracoscopic Surgery in Elderly Patients with Blunt Traumatic Hemothorax without an Initial Thoracostomy

    Science.gov (United States)

    Huang, Wen-Yen; Lu, I-Yin; Yang, Chyan; Chou, Yi-Pin; Lin, Hsing-Lin

    2016-01-01

    Hemothorax is common in elderly patients following blunt chest trauma. Traditionally, tube thoracostomy is the first choice for managing this complication. The goal of this study was to determine the benefits of this approach in elderly patients with and without an initial tube thoracostomy. Seventy-eight patients aged >65 years with blunt chest trauma and stable vital signs were included. All of them had more than 300 mL of hemothorax, indicating that a tube thoracostomy was necessary. The basic demographic data and clinical outcomes of patients with hemothorax who underwent direct video-assisted thoracoscopic surgery without a tube thoracostomy were compared with those who received an initial tube thoracostomy. Patients who did not receive a thoracostomy had lower posttrauma infection rates (28.6% versus 56.3%, P = 0.061) and a significantly shorter length of stay in the intensive care unit (3.13 versus 8.27, P = 0.029) and in the hospital (15.93 versus 23.17, P = 0.01) compared with those who received a thoracostomy. The clinical outcomes in the patients who received direct VATS were more favorable compared with those of the patients who did not receive direct VATS.

  6. Efficiency Analysis of Direct Video-Assisted Thoracoscopic Surgery in Elderly Patients with Blunt Traumatic Hemothorax without an Initial Thoracostomy

    Directory of Open Access Journals (Sweden)

    Wen-Yen Huang

    2016-01-01

    Full Text Available Hemothorax is common in elderly patients following blunt chest trauma. Traditionally, tube thoracostomy is the first choice for managing this complication. The goal of this study was to determine the benefits of this approach in elderly patients with and without an initial tube thoracostomy. Seventy-eight patients aged >65 years with blunt chest trauma and stable vital signs were included. All of them had more than 300 mL of hemothorax, indicating that a tube thoracostomy was necessary. The basic demographic data and clinical outcomes of patients with hemothorax who underwent direct video-assisted thoracoscopic surgery without a tube thoracostomy were compared with those who received an initial tube thoracostomy. Patients who did not receive a thoracostomy had lower posttrauma infection rates (28.6% versus 56.3%, P=0.061 and a significantly shorter length of stay in the intensive care unit (3.13 versus 8.27, P=0.029 and in the hospital (15.93 versus 23.17, P=0.01 compared with those who received a thoracostomy. The clinical outcomes in the patients who received direct VATS were more favorable compared with those of the patients who did not receive direct VATS.

  7. Blunt Head Trauma and Headache

    Directory of Open Access Journals (Sweden)

    Ana B Chelse

    2015-04-01

    Full Text Available Investigators from New York Presbyterian Morgan Stanley Children’s Hospital examined whether having an isolated headache following minor blunt head trauma was suggestive of traumatic brain injury (TBI among a large cohort of children 2-18 years of age.

  8. Mathematical model of blunt injury to the vascular wall via formation of rouleaux and changes in local hemodynamic and rheological factors. Implications for the mechanism of traumatic myocardial infarction

    Directory of Open Access Journals (Sweden)

    Ismailov Rovshan M

    2005-03-01

    Full Text Available Abstract Background Blood viscosity is fundamentally important in clinical practice yet the apparent viscosity at very low shear rates is not well understood. Various conditions such as blunt trauma may lead to the appearance of zones inside the vessel where shear stress equals zero. The aim of this research was to determine the blood viscosity and quantitative aspects of rouleau formation from erythrocytes at yield velocity (and therefore shear stress equal to zero. Various fundamental differential equations and aspects of multiphase medium theory have been used. The equations were solved by a method of approximation. Experiments were conducted in an aerodynamic tube. Results The following were determined: (1 The dependence of the viscosity of a mixture on volume fraction during sedimentation of a group of particles (forming no aggregates, confirmed by published experimental data on the volume fractions of the second phase (f2 up to 0.6; (2 The dependence of the viscosity of the mixture on the volume fraction of erythrocytes during sedimentation of rouleaux when yield velocity is zero; (3 The increase in the viscosity of a mixture with an increasing erythrocyte concentration when yield velocity is zero; (4 The dependence of the quantity of rouleaux on shear stress (the higher the shear stress, the fewer the rouleaux and on erythrocyte concentration (the more erythrocytes, the more rouleaux are formed. Conclusions This work represents one of few attempts to estimate extreme values of viscosity at low shear rate. It may further our understanding of the mechanism of blunt trauma to the vessel wall and therefore of conditions such as traumatic acute myocardial infarction. Such estimates are also clinically significant, since abnormal values of blood viscosity have been observed in many pathological conditions such as traumatic crush syndrome, cancer, acute myocardial infarction and peripheral vascular disease.

  9. Case report: Methotrexate-induced pericardial effusion

    OpenAIRE

    Dündar, Betül; Karalök, Alper; Üreyen, Işın; Gündoğdu, Burcu; Öçalan, Reyhan; Taner TURAN; Boran, Nurettin; Tulunay, Gökhan; Köse, M. Faruk

    2013-01-01

    We report a case of pericardial effusion induced by methotrexate in a patient with low risk gestational trophoblastic neoplasia, who had been taking the first course of sequential methotrexate-folinic acid treatment. After aspiration of pericardial effusion another methotrexate-folinic acid course was given and the pericardial effusion did not relapse.

  10. Traumatic bilateral carotid artery dissection following severe blunt trauma: a case report on the difficulties in diagnosis and therapy of an often overlooked life-threatening injury

    OpenAIRE

    Crönlein, Moritz; Sandmann, Gunther H.; Beirer, Marc; Wunderlich, Silke; Biberthaler, Peter; Huber-Wagner, Stefan

    2015-01-01

    Background Traumatic carotid artery dissections are very rare, often overlooked and life-threatening injuries. Diagnosis and treatment are difficult especially in multiple injured patients. Case presentation We report on a 28-year-old female major trauma patient (injury severity score, ISS 50) who was involved in a motor vehicle accident. She was primarily transferred to a level II trauma center. After initial assessment and operative management, an anisocoria was diagnosed on the intensive c...

  11. Survival post surgery for malignant pericardial effusion

    Directory of Open Access Journals (Sweden)

    Olivier Nguyen

    2011-05-01

    Full Text Available The study reviews the survival of patients with malignant pericardial effusion treated with a subxiphoid pericardial window. The medical records of 60 consecutive patients diagnosed with a malignant pericardial effusion and treated with a subxiphoid pericardial window between 1994 and 2008 were reviewed. 72% had lung cancer. Overall 30-day mortality was 31%. Survival rates at 3 months, 6 months, 1 year, and 2 years were 45%, 28%, 17%, and 9%, respectively. Overall median survival was 2.6 months. Patients with malignant pericardial effusion, especially those with primary lung cancer have poor survival rates. In advanced malignancy, the subxiphoid pericardial window procedure provides only short-term palliation of symptoms, and has no effect on long-term survival. The use of any surgical procedure in patients with malignant advanced pericardial effusion should be considered along with nonsurgical options on a case-by-case basis depending on symptoms, general status, and expected survival.

  12. Anterior capsular rupture following blunt ocular injury

    OpenAIRE

    Gremida, Anas; Kassem, Iris; Traish, Aisha

    2011-01-01

    A 10-year-old boy suffered a large, oblique anterior capsular tear following blunt injury to his right eye. The boy was followed daily for hyphema resolution and progressive traumatic cataract formation. After the hyphema had resolved, the lens was removed using an anterior approach and an intraocular lens was placed with excellent visual outcome.

  13. Blunt abdominal trauma with transanal small bowel evisceration

    Directory of Open Access Journals (Sweden)

    Noushif Medappil

    2013-01-01

    Full Text Available Small bowel evisceration through the anus can occur spontaneously or post traumatically. Traumatic transanal small bowel evisceration results from iatrogenic injuries, suction injuries, and blunt abdominal trauma (BAT. We report a 48-year-old female who presented with evisceration of small intestinal loops through the anus following BAT and discuss the etiologies and mechanisms of injury of this rare presentation.

  14. [Right atrium rupture due to blunt trauma].

    Science.gov (United States)

    Suzuki, Kazuhiro; Thuboi, H; Okada, H

    2008-03-01

    We report 2 cases of surgical treatment of blunt cardiac trauma. The postoperative course was uneventful in either case. Pericardial drainage in patients with cardiac rupture should be performed with preparation for thoracotomy. Case 1: A 34-year-old male, hit in the chest by a collapsing 700-kg steel rod, was transported to our hospital via ambulance. The patient was diagnosed as having a cardiac rupture by echocardiography and underwent emergency thoracotomy. The right atrium near the inferior vena cava (IVC) was damaged, though bleeding from the wound had already ceased. No suture hemostusis was needed. Case 2: A 63-year-old female was hit by a car and transported to our hospital due to blunt trauma to the chest. Low blood pressure and chest computed tomography demonstrated cardiac tamponade, and subxiphoid pericardial drainage was performed. Blood pressure was recovered, but persistent hemorrhage necessitated emergency thoracotomy, which revealed a laceration at the right atrium near IVC. The injury was sutured to achieve complete hemostasis. PMID:18323181

  15. Massive pericardial effusion in a hypothyroid child.

    OpenAIRE

    Williams, L H; Jayatunga, R.; Scott, O

    1984-01-01

    A child with Down's syndrome and long standing severe hypothyroidism had a massive pericardial effusion without cardiac tamponade. The effusion completely resolved with medical treatment without pericardiocentesis.

  16. Blunt Facial Trauma Causing Isolated Optic Nerve Hematoma

    Directory of Open Access Journals (Sweden)

    R. Parab

    2013-01-01

    Full Text Available Traumatic optic neuropathy is an uncommon, yet serious, result of facial trauma. The authors present a novel case of a 59-year-old gentleman who presented with an isolated blunt traumatic left optic nerve hematoma causing vision loss. There were no other injuries or fractures to report. This case highlights the importance of early recognition of this rare injury and reviews the current literature and management of traumatic optic neuropathy.

  17. Neoplastic pericardial disease. Analysis of 26 patients

    Directory of Open Access Journals (Sweden)

    Helena Nogueira Soufen

    1999-01-01

    Full Text Available PURPOSE: To characterize patients with neoplastic pericardial disease diagnosed by clinical presentation, complementary test findings, and the histological type of tumor. METHODS: Twenty-six patients with neoplastic pericardial disease were retrospectively analyzed. RESULTS: Clinical manifestations and abnormalities in chest roentgenograms and electrocardiograms were frequent, but were not specific. Most patients underwent surgery. There was a high positivity of the pericardial biopsy when associated with the cytological analysis of the pericardial liquid used to determine the histological type of the tumor, particularly when the procedure was performed with the aid of pericardioscopy. CONCLUSION: The correct diagnosis of neoplastic pericardial disease involves suspicious but nonspecific findings during clinical examination and in screen tests. The suspicious findings must be confirmed through more invasive diagnostic approaches, in particular pericardioscopy with biopsy and cytological study.

  18. Pulmonary lesions mimicking pericardial effusion on ultrasonography

    International Nuclear Information System (INIS)

    Two children with right middle lobe lesions mimicking pericardial effusion on ultrasonography are presented. They were admitted with fever and chest radiographs showed atelectasis or consolidation of the middle lobe of the right lung along the right heart border. A low-echogenic layer suggesting pericardial fluid was seen on ultrasonography, but with a spatial distribution closely corresponding to the lesions seen on the chest radiographs. If the possibility that a lung lesion adjacent to the heart can simulate pericardial fluid on ultrasonography is kept in mind, the correct diagnosis should not be difficult to make. (orig.)

  19. The efficacy of VATS, subxiphoid and minithoracotomy pericardial window for surgical management of symptomatic pericardial effusions

    Directory of Open Access Journals (Sweden)

    Sezai Çelik

    2014-03-01

    Full Text Available Objective: Pericardial effusion potentially cause significant morbidity and mortality. Pericardial window by video-assisted thoracic surgery (VATS, subxiphoid and minithoracotomy is available surgical treatment options. The aim of this study is to determine the efficacy and outcome of the three different methods for surgical management of symptomatic pericardial effusions. Methods: A retrospective study of patients operated for pericardial effusion between October 2007 to December 2011 at Dr. Siyami Ersek Hospital were divided into three groups according to surgical treatment d: Group 1 (VATS, n=24, Group 2 (Subxiphoid, n=28 Group 3 (Minithoracotomy, n=36. The groups were analyzed and compared using demographic information, operative and postoperative details and course, recurrence, follow-up data, morbidity, mortality and survival. Results: A total of 88 patients (37 women, 51 men, with mean age 54.47±16.81 underwent pericardial window were included in the study. The groups had similar perioperative characteristics except sex distribution and etiology. VATS, Subxiphoid and minithoracotomy pericardial window were well tolerated by patients, resulted in similar rates of mortality, 30-day mortality, overall postoperative complications, recurrence rates and survival. Operative time was significantly shorter in group 3 (p0.05. Group 2 had a significantly higher lenght of hospital stay (p<0.05. Conclusion: Minithoracotomy pericardial window provides rapid and definitive diagnosis and treatment for pericardial effusions of all causes acceptable morbidity rates. On the other hand, VATS and subxiphoid pericardial window should be performed in selected cases.

  20. Transient Myopia and Hypotonia after Blunt Eye Trauma

    OpenAIRE

    Müge Çoban Karataf; Aysel Pelit; Yonca Ayd›n Akova

    2011-01-01

    A patient whot received blunt trauma to the right eye one week ago referred to our clinic with complaints of low vision. Traumatic mMyopia and hypotonia were detected in the same eye after full ophthalmologic examination. The complaints of the patient completely disappeared after two weeks of medical treatment. Transient myopia and hypotonia after blunt ocular trauma may be temporary. After full ophthalmologic examination, proper treatment should be applied. (Turk J Ophthalmol 201...

  1. Cardiovascular magnetic resonance in pericardial diseases

    OpenAIRE

    Francone Marco; Bogaert Jan

    2009-01-01

    Abstract The pericardium and pericardial diseases in particular have received, in contrast to other topics in the field of cardiology, relatively limited interest. Today, despite improved knowledge of pathophysiology of pericardial diseases and the availability of a wide spectrum of diagnostic tools, the diagnostic challenge remains. Not only the clinical presentation may be atypical, mimicking other cardiac, pulmonary or pleural diseases; in developed countries a shift for instance in the ep...

  2. The effects of blunt trauma and cataract surgery on corneal endothelial cell density

    OpenAIRE

    Yeniad Baris; Corum Isik; Ozgun Cahit

    2010-01-01

    Purpose: This study was designed to investigate the effects of trauma and cataract surgery on corneal endothelial cell density (ECD) in patients with a traumatic cataract due to blunt trauma without globe laceration. Materials and Methods: In this prospective study, 31 subjects with traumatic cataract (traumatic cataract group) and 30 subjects with a senile cataract (control group) were enrolled. The subjects with traumatic cataract were subdivided into two groups: uncomplicated surgery subg...

  3. Amebic pericardial effusion: a rare complication of amebic liver abscess.

    Science.gov (United States)

    Agrawal, B V; Somani, P N; Khanna, M N; Srivastava, P K; Jha, B N; Verma, S P

    1975-06-01

    Two rare cases of amebic pericardial effusion as a complication of amoebic liver abscess in the left lobe are described. The pericardial amebiasis should be suspected in a patient presenting with signs and symptoms of pericardial effusion with an evidence of hepatic abscess (in the left lobe) or in a patient with pericardial effusion of uncertain etiology. Aspiration of "anchovy sauce" pus from both the pericardial cavity and the liver should be regarded as confirming the diagnosis of amebic pericarditis secondary to amebic liver abcess because demonstration of Entamoeba hystolytica is seldom possible. Removal of pericardial pus and metronidazole intake were markedly effective in treating our patients. PMID:123716

  4. Cardiovascular magnetic resonance in pericardial diseases

    Directory of Open Access Journals (Sweden)

    Francone Marco

    2009-05-01

    Full Text Available Abstract The pericardium and pericardial diseases in particular have received, in contrast to other topics in the field of cardiology, relatively limited interest. Today, despite improved knowledge of pathophysiology of pericardial diseases and the availability of a wide spectrum of diagnostic tools, the diagnostic challenge remains. Not only the clinical presentation may be atypical, mimicking other cardiac, pulmonary or pleural diseases; in developed countries a shift for instance in the epidemiology of constrictive pericarditis has been noted. Accurate decision making is crucial taking into account the significant morbidity and mortality caused by complicated pericardial diseases, and the potential benefit of therapeutic interventions. Imaging herein has an important role, and cardiovascular magnetic resonance (CMR is definitely one of the most versatile modalities to study the pericardium. It fuses excellent anatomic detail and tissue characterization with accurate evaluation of cardiac function and assessment of the haemodynamic consequences of pericardial constraint on cardiac filling. This review focuses on the current state of knowledge how CMR can be used to study the most common pericardial diseases.

  5. Pericardial effusions in two boys with chronic granulomatous disease

    International Nuclear Information System (INIS)

    Pericardial involvement in chronic granulomatous disease (CGD) is very rare. We present two children with known CGD and pericardial effusions in whom no microbial cause for the effusions was found. (orig.)

  6. Complimentary imaging technologies in blunt ocular trauma

    Directory of Open Access Journals (Sweden)

    Anton M Kolomeyer

    2013-01-01

    Full Text Available We describe complimentary imaging technologies in traumatic chorioretinal injury. Color and fundus autofluorescence (FAF images were obtained with a non-mydriatic retinal camera. Optical coherence tomography (OCT helped obtain detailed images of retinal structure. Microperimetry was used to evaluate the visual function. A 40-year-old man sustained blunt ocular trauma with a stone. Color fundus image showed a large chorioretinal scar in the macula. Software filters allowed detailed illustration of extensive macular fibrosis. A 58-year-old man presented with blunt force trauma with a tennis ball. Color fundus imaging showed a crescentric area of macular choroidal rupture with fibrosis. FAF imaging delineated an area of hypofluorescence greater on fundus imaging. OCT showed chorioretinal atrophy in the macula. Microperimetry delineated an absolute scotoma with no response to maximal stimuli. Fundus imaging with digital filters and FAF illustrated the full extent of chorioretinal injury, while OCT and microperimetry corroborated the structure and function correlations.

  7. Aortic reconstruction with bovine pericardial grafts

    Directory of Open Access Journals (Sweden)

    Silveira Lindemberg Mota

    2003-01-01

    Full Text Available INTRODUCTION: Glutaraldehyde-treated crimped bovine pericardial grafts are currently used in aortic graft surgery. These conduits have become good options for these operations, available in different sizes and shapes and at a low cost. OBJECTIVE:To evaluate the results obtained with bovine pericardial grafts for aortic reconstruction, specially concerning late complications. METHOD: Between January 1995 and January 2002, 57 patients underwent different types of aortic reconstruction operations using bovine pericardial grafts. A total of 29 (50.8% were operated on an urgent basis (mostly acute Stanford A dissection and 28 electively. Thoracotomy was performed in three patients for descending aortic replacement (two patients and aortoplasty with a patch in one. All remaining 54 underwent sternotomy, cardiopulmonary bypass and aortic resection. Deep hypothermia and total circulatory arrest was used in acute dissections and arch operations. RESULTS: Hospital mortality was 17.5%. Follow-up was 24.09 months (18.5 to 29.8 months confidence interval and complication-free actuarial survival curve was 92.3% (standard deviation ± 10.6. Two patients lately developed thoracoabdominal aneurysms following previous DeBakey II dissection and one died from endocarditis. One "patch" aortoplasty patient developed local descending aortic pseudoaneurysm 42 months after surgery. All other patients are asymptomatic and currently clinically evaluated with echocardiography and CT scans, showing no complications. CONCLUSION: Use of bovine pericardial grafts in aortic reconstruction surgery is adequate and safe, with few complications related to the conduits.

  8. Mathematical model of blunt injury to the vascular wall via formation of rouleaux and changes in local hemodynamic and rheological factors. Implications for the mechanism of traumatic myocardial infarction

    OpenAIRE

    Ismailov, Rovshan M

    2005-01-01

    Background Blood viscosity is fundamentally important in clinical practice yet the apparent viscosity at very low shear rates is not well understood. Various conditions such as blunt trauma may lead to the appearance of zones inside the vessel where shear stress equals zero. The aim of this research was to determine the blood viscosity and quantitative aspects of rouleau formation from erythrocytes at yield velocity (and therefore shear stress) equal to zero. Various fundamental differential ...

  9. Mathematical model of blunt injury to the vascular wall via formation of rouleaux and changes in local hemodynamic and rheological factors. Implications for the mechanism of traumatic myocardial infarction

    OpenAIRE

    Ismailov Rovshan M

    2005-01-01

    Abstract Background Blood viscosity is fundamentally important in clinical practice yet the apparent viscosity at very low shear rates is not well understood. Various conditions such as blunt trauma may lead to the appearance of zones inside the vessel where shear stress equals zero. The aim of this research was to determine the blood viscosity and quantitative aspects of rouleau formation from erythrocytes at yield velocity (and therefore shear stress) equal to zero. Various fundamental diff...

  10. Intrathoracic Kidney after Blunt Abdominal Trauma: A Case Report and Review of the Literature.

    Science.gov (United States)

    Halis, Fikret; Amasyali, Akin Soner; Yucak, Aysel; Yildiz, Turan; Gokce, Ahmet

    2015-01-01

    Abdominal trauma is responsible for most genitourinary injuries. The incidence of renal artery injury and intrathoracic kidney is quite low in patients who present with blunt trauma experiencing damage. There are four defined etiologies for intrathoracic kidney, which include real intrathoracic ectopic kidney, eventration of the diaphragm, congenital diaphragmatic herniation, and traumatic diaphragmatic rupture. The traumatic intrathoracic kidney is an extremely rare case. We presented intrathoracic kidney case after traumatic posterior diaphragmatic rupture. PMID:26881170

  11. Multidetector Computer Tomography: Evaluation of Blunt Chest Trauma in Adults

    Directory of Open Access Journals (Sweden)

    João Palas

    2014-01-01

    Full Text Available Imaging plays an essential part of chest trauma care. By definition, the employed imaging technique in the emergency setting should reach the correct diagnosis as fast as possible. In severe chest blunt trauma, multidetector computer tomography (MDCT has become part of the initial workup, mainly due to its high sensitivity and diagnostic accuracy of the technique for the detection and characterization of thoracic injuries and also due to its wide availability in tertiary care centers. The aim of this paper is to review and illustrate a spectrum of characteristic MDCT findings of blunt traumatic injuries of the chest including the lungs, mediastinum, pleural space, and chest wall.

  12. Multidetector Computer Tomography: Evaluation of Blunt Chest Trauma in Adults

    International Nuclear Information System (INIS)

    Imaging plays an essential part of chest trauma care. By definition, the employed imaging technique in the emergency setting should reach the correct diagnosis as fast as possible. In severe chest blunt trauma, multidetector computer tomography (MDCT) has become part of the initial workup, mainly due to its high sensitivity and diagnostic accuracy of the technique for the detection and characterization of thoracic injuries and also due to its wide availability in tertiary care centers. The aim of this paper is to review and illustrate a spectrum of characteristic MDCT findings of blunt traumatic injuries of the chest including the lungs, mediastinum, pleural space, and chest wall.

  13. Spontaneous pericardial mesothelioma in a rhesus monkey.

    Science.gov (United States)

    Chandra, M; Mansfield, K G

    1999-06-01

    Spontaneous tumors in nonhuman primates are of great importance. A spontaneous pericardial mesothelioma was observed in an 18-year-old female rhesus monkey. Grossly, the visceral pericardium was multifocally irregular and thickened with tan discoloration and was soft in consistency. Histologically, the pericardium contained highly in-folded branching fronds lined by a single layer of cuboidal cells. Tumor invaded into approximately half of the thickness of the atrial and ventricular muscles. Tumor penetration was not observed into the atrial or ventricular cavity. Within the myocardium, neoplastic cells formed glandular structures which were lined by cuboidal to columnar cells. Neoplastic cells were weakly positive with PAS and strongly positive for colloid iron and alcian blue. Immunohistochemically, neoplastic cells were positive for both vimentin and cytokeratin and negative with CEA and Leu-M1, indicating mesothelial origin. To the best of the authors' knowledge, this is the first report of a spontaneous pericardial mesothelioma in a rhesus monkey. PMID:10475114

  14. Pericardial effusions in two boys with chronic granulomatous disease.

    OpenAIRE

    Macedo, F.; McHugh, K; Goldblatt, D

    1999-01-01

    Pediatr Radiol. 1999 Nov;29(11):820-2. Pericardial effusions in two boys with chronic granulomatous disease. Macedo F, McHugh K, Goldblatt D. SourceDepartment of Radiology, Hospital Geral de Santo Antonio, Porto, Portugal. Abstract Pericardial involvement in chronic granulomatous disease (CGD) is very rare. We present two children with known CGD and pericardial effusions in whom no microbial cause for the effusions was found. PMID: 10552060 [PubMed - indexed for MEDLINE

  15. MRI Findings of Pericardial Fat Necrosis: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyo Hyeok; Ryu, Dae Shick; Jung, Sang Sig; Jung, Seung Mun; Choi, Soo Jung; Shin, Dae Hee [Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung (Korea, Republic of)

    2011-06-15

    Pericardial fat necrosis is an infrequent cause of acute chest pain and this can mimic acute myocardial infarction and acute pericarditis. We describe here a patient with the magnetic resonance imaging (MRI) findings of pericardial fat necrosis and this was correlated with the computed tomography (CT) findings. The MRI findings may be helpful for distinguishing pericardial fat necrosis from other causes of acute chest pain and from the fat-containing tumors in the cardiophrenic space of the anterior mediastinum.

  16. Blunt force trauma to skull with various instruments.

    Science.gov (United States)

    Sulaiman, Nur Amirah; Osman, Khairul; Hamzah, Noor Hazfalinda; Amir, Sri Pawita Albakri

    2014-04-01

    Deaths due to blunt force trauma to the head as a result of assault are some of the most common cases encountered by the practicing forensic pathologist. Previous studies have shown inflicting injury to the head region is one of the most effective methods of murder. The important factors that determine severity of trauma include the type of weapon used, type and site of skull fracture, intracranial haemorrhage and severity of brain injury. The aim of this study was to determine the characteristics of blunt force trauma to the skull produced by different instruments. Nine adult monkeys (Macaca fascicularis) skulls were used as models. Commonly found blunt objects comprising of Warrington hammer, hockey stick and open face helmet were used in this study. A machine calibrated force generator was used to hold the blunt object in place and to hit the skulls at forces of 12.5N and 25N. Resultant traumatic effects and fractures (linear, depressed, basilar, comminuted, and distastic) were analyzed according to type of blunt object used; surface area of contact and absolute force (N/cm(2)) delivered. Results showed that all investigated instruments were capable of producing similar injuries. The severity of trauma was not related to the surface area of contact with the blunt objects. However, only high absolute forces produced comminuted fractures. These findings were observational, as the samples were too small for statistical conclusions. PMID:24763233

  17. Traumatic Gallbladder Rupture Treated by Laparoscopic Cholecystectomy

    Science.gov (United States)

    Egawa, Noriyuki; Ueda, Junji; Hiraki, Masatsugu; Ide, Takao; Inoue, Satoshi; Sakamoto, Yuichiro; Noshiro, Hirokazu

    2016-01-01

    Abstract Gallbladder rupture due to blunt abdominal injury is rare. There are few reports of traumatic gallbladder injury, and it is commonly associated with other concomitant visceral injuries. Therefore, it is difficult to diagnose traumatic gallbladder rupture preoperatively when it is caused by blunt abdominal injury. We report a patient who underwent laparoscopic cholecystectomy after an exact preoperative diagnosis of traumatic gallbladder rupture. A 43-year-old man was admitted to our hospital due to blunt abdominal trauma. The day after admission, abdominal pain and ascites increased and a muscular defense sign appeared. Percutaneous drainage of the ascites was performed, and the aspirated fluid was bloody and almost pure bile. He was diagnosed with gallbladder rupture by the cholangiography using the endoscopic retrograde cholangiopancreatography technique. Laparoscopic cholecystectomy was performed safely, and he promptly recovered. If accumulated fluids contain bile, endoscopic cholangiography is useful not only to diagnose gallbladder injury but also to determine the therapeutic strategy. PMID:27462188

  18. Surgical management for the first 48 h following blunt chest trauma: state of the art (excluding vascular injuries).

    Science.gov (United States)

    de Lesquen, Henri; Avaro, Jean-Philippe; Gust, Lucile; Ford, Robert Michael; Beranger, Fabien; Natale, Claudia; Bonnet, Pierre-Mathieu; D'Journo, Xavier-Benoît

    2015-03-01

    This review aims to answer the most common questions in routine surgical practice during the first 48 h of blunt chest trauma (BCT) management. Two authors identified relevant manuscripts published since January 1994 to January 2014. Using preferred reporting items for systematic reviews and meta-analyses statement, they focused on the surgical management of BCT, excluded both child and vascular injuries and selected 80 studies. Tension pneumothorax should be promptly diagnosed and treated by needle decompression closely followed with chest tube insertion (Grade D). All traumatic pneumothoraces are considered for chest tube insertion. However, observation is possible for selected patients with small unilateral pneumothoraces without respiratory disease or need for positive pressure ventilation (Grade C). Symptomatic traumatic haemothoraces or haemothoraces >500 ml should be treated by chest tube insertion (Grade D). Occult pneumothoraces and occult haemothoraces are managed by observation with daily chest X-rays (Grades B and C). Periprocedural antibiotics are used to prevent chest-tube-related infectious complications (Grade B). No sign of life at the initial assessment and cardiopulmonary resuscitation duration >10 min are considered as contraindications of Emergency Department Thoracotomy (Grade C). Damage Control Thoracotomy is performed for either massive air leakage or refractive shock or ongoing bleeding enhanced by chest tube output >1500 ml initially or >200 ml/h for 3 h (Grade D). In the case of haemodynamically stable patients, early video-assisted thoracic surgery is performed for retained haemothoraces (Grade B). Fixation of flail chest can be considered if mechanical ventilation for 48 h is probably required (Grade B). Fixation of sternal fractures is performed for displaced fractures with overlap or comminution, intractable pain or respiratory insufficiency (Grade D). Lung herniation, traumatic diaphragmatic rupture and pericardial rupture are life

  19. The blunt abdominal trauma

    International Nuclear Information System (INIS)

    Up to 1970 the number of patients suffering from blunt abdominal trauma showed a substantial increase. In more than 50% of all cases there are additional injuries. The most important factor influencing the prognosis of these patients is the early and correct indication for operation and the avoidance of unnecessary laparotomies. As a primary aim in diagnosis one should consider the recognition of an intraperitoneal bleeding without risk for the patient. Peritoneal lavage as an invasive method with low complication rates has proved good. First reports also show good results using the sonography of the abdomen. The recognition of the injured organ allows a carefully directed operation. Concerning the prognosis it is of minor importance. The diagnosis in patients with blunt abdominal trauma at the university clinic of Freiburg consists of: sonography, followed in positive cases by laparotomy or angiography and laparotomy. In cases with questionable results a lavage is done. (orig.)

  20. Pneumoperitoneum in a patient with pneumothorax and blunt neck trauma

    Directory of Open Access Journals (Sweden)

    Suhail Yaqoob Hakim

    2014-01-01

    CONCLUSION: Free air in the abdomen after blunt traumatic neck injury is very rare. If pneumoperitoneum is suspected in the presence of pneumothorax, exploratory laparotomy should be performed to rule out intraabdominal injury. As, there is no consensus for this plan yet, further prospective studies are warrant. Conservative management for pneumoperitoneum in the absence of viscus perforation is still a safe option in carefully selected cases.

  1. Computed tomography for the assessment of blunt abdominal trauma

    International Nuclear Information System (INIS)

    Computed tomography (CT) was carried out on 70 patients with blunt abdominal trauma. Damage to the abdominal organs was clearly demonstrated by CT. The positive rates of CT in traumatic lesions were higher than those of ultrasound (US). Intraperitoneal hemorrhage was well demonstrated by US. Serum GPT levels were significantly elevated in patients with liver damage (p<0.001). CT proved to be useful for detecting damage to organs in patients with abdominal trauma. (author)

  2. Paediatric Blunt Torso Trauma

    Science.gov (United States)

    Bhatti, Khalid M.; Taqi, Kadhim M.; Al-Harthy, Ahmed Z. S.; Hamid, Rana S.; Al-Balushi, Zainab N.; Sankhla, Dilip K.; Al-Qadhi, Hani A.

    2016-01-01

    Objectives: Trauma is the greatest cause of morbidity and mortality in paediatric/adolescent populations worldwide. This study aimed to describe trauma mechanisms, patterns and outcomes among children with blunt torso trauma admitted to the Sultan Qaboos University Hospital (SQUH) in Muscat, Oman. Methods: This retrospective single-centre study involved all children ≤12 years old with blunt torso trauma admitted for paediatric surgical care at SQUH between January 2009 and December 2013. Medical records were analysed to collect demographic and clinical data. Results: A total of 70 children were admitted with blunt torso trauma during the study period, including 39 (55.7%) male patients. The mean age was 5.19 ± 2.66 years. Of the cohort, 35 children (50.0%) received their injuries after having been hit by cars as pedestrians, while 19 (27.1%) were injured by falls, 12 (17.1%) during car accidents as passengers and four (5.7%) by falling heavy objects. According to computed tomography scans, thoracic injuries were most common (65.7%), followed by abdominal injuries (42.9%). The most commonly involved solid organs were the liver (15.7%) and spleen (11.4%). The majority of the patients were managed conservatively (92.9%) with a good outcome (74.3%). The mortality rate was 7.1%. Most deaths were due to multisystem involvement. Conclusion: Among children with blunt torso trauma admitted to SQUH, the main mechanism of injury was motor vehicle accidents. As a result, parental education and enforcement of infant car seat/child seat belt laws are recommended. Conservative management was the most successful approach. PMID:27226913

  3. A case of tuberculous pericardial effusion

    Directory of Open Access Journals (Sweden)

    Wanjari K

    2009-01-01

    Full Text Available Tuberculosis accounts for up to 4% of acute pericarditis and 7% cases of cardiac tamponade. Prompt treatment can be life saving but requires accurate diagnosis. We report a case of 30-year-old male who presented with fever, chills, and dry nonproductive cough since one month. The case was diagnosed by radiological findings, which were suggestive of pulmonary tuberculosis, followed by acid fast staining and culture of the aspirated pericardial fluid. The patient was responding to antitubercular treatment at the last follow up.

  4. CT features of a pericardial gossypiboma

    Energy Technology Data Exchange (ETDEWEB)

    Coskun, M.; Boyvat, F.; Muhtesem Agildere, A. [Dept. of Radiology, Baskent Univ. Hospital, Ankara (Turkey)

    1999-05-01

    We report a case of surgically retained pericardial sponge as a cause of paracardiac mass in a woman who had thoracotomy 3 weeks prior for replacement of mitral valve prosthesis. Computed tomography examination showed a thin-walled mass containing relatively high-density material in the central part with low-density rim at the periphery suggesting a haematoma with clot formation at first. Surgically removed mass was a retained sponge between right atrium and pericardium. Gossypiboma should be included in the differential diagnosis of an intrathoracic mass besides haematoma and abscess formation in any patient who has had previous thoracotomy. (orig.) With 1 fig., 14 refs.

  5. CT features of a pericardial gossypiboma

    International Nuclear Information System (INIS)

    We report a case of surgically retained pericardial sponge as a cause of paracardiac mass in a woman who had thoracotomy 3 weeks prior for replacement of mitral valve prosthesis. Computed tomography examination showed a thin-walled mass containing relatively high-density material in the central part with low-density rim at the periphery suggesting a haematoma with clot formation at first. Surgically removed mass was a retained sponge between right atrium and pericardium. Gossypiboma should be included in the differential diagnosis of an intrathoracic mass besides haematoma and abscess formation in any patient who has had previous thoracotomy. (orig.)

  6. Blunt cardiac rupture.

    Science.gov (United States)

    Martin, T D; Flynn, T C; Rowlands, B J; Ward, R E; Fischer, R P

    1984-04-01

    Blunt injury to the heart ranges from contusion to disruption. This report comprises 14 patients seen during a 6-year period with cardiac rupture secondary to blunt trauma. Eight patients were injured in automobile accidents, two patients were injured in auto-pedestrian accidents, two were kicked in the chest by ungulates, and two sustained falls. Cardiac tamponade was suspected in ten patients. Five patients presented with prehospital cardiac arrest or arrested shortly after arrival. All underwent emergency department thoracotomy without survival. Two patients expired in the operating room during attempted cardiac repair; both had significant extracardiac injury. Seven patients survived, three had right atrial injuries, three had right ventricular injuries, and one had a left atrial injury. Cardiopulmonary bypass was not required for repair of the surviving patients. There were no significant complications from the cardiac repair. The history of significant force dispersed over a relatively small area of the precordium as in a kicking injury from an animal or steering wheel impact should alert the physician to possible cardiac rupture. Cardiac rupture should be considered in patients who present with signs of cardiac tamponade or persistent thoracic bleeding after blunt trauma. PMID:6708151

  7. Pericardial effusion and cardiac tamponade in a dog with hypothyroidism

    Directory of Open Access Journals (Sweden)

    J Ojeda

    2015-01-01

    Full Text Available The relationship between hypothyroidism and cardiovascular diseases in dogs is frequently associated with clinical signs like sinusal bradicardia, myocardial alterations and ECG findings such as low voltage QRS and inverted T wave. Echocardiographic studies in hypothyroid dogs have not identified pericardial effusion. Hypothyroidism in human patients is a well-known cause of pericardial effusion, but cardiac tamponade is not a frequent clinical sign. A Golden Retriever was presented with a clinical history of progressive lethargy, exercise intolerance, cold intolerance and increased respiratory effort for 3 weeks. At the clinical examination the dog presented dyspnea, muffled heart sound and hypertension. Echocardiography showed fluid in the pericardial sac and cardiac tamponade and pericardiocentesis was performed. Analyses of the fluid showed a non-neoplastic etiology. The information given by the owners, the alopecia zones detected in tail and abdomen and the clinical response, led to analise the thyroid hormones, and hypothyroidism was confirmed. Following two pericardiocentesis and levothyroxine supplementation, the effusion resolved. Although the etiology of pericardial effusion was not clear, it is possible that the pericardial effusion had been caused by hypothyroidism or the dog had idiophatic pericardial effusion and coincidental hypothyroidism. However, according to the clinical signs and the evolution of the dog, an evaluation of thyroid hormones in dogs with pericardial effusion must be considered even though pericardial effusion is a non-described sign in canine hypothyroidism.

  8. Huge Pericardial Cyst Misleading Symptoms of COPD

    Directory of Open Access Journals (Sweden)

    Göktürk Fındık

    2012-04-01

    Full Text Available Pericardial cysts are rare benign congenital mediastinal lesions. It accounts 30% of all mediastinal cysts. They are usually asemptomatic. They can produce the compression of the mediastinal structures typically caused the symptoms of dyspnea, thoracic pain, tachicardia and cough due to the unusual large size of the cyst. It can performed symptoms of lung atelectasia. The case was a sixty-five years old woman followed with a diagnosis of COPD for seven years. The patient was admitted to our center with the diagnosis of elevation of the right hemidiaphragm on chest radiography. The computed tomography revealed a cystic lesion adjacent to the right hemidiaphragm and cyst excision was performed via right thoracotomy. Patient%u2019s postoperative clinical findings indicated that the symptoms of COPD regressed completely and the patient did not require any further bronchodilator therapy. The aim of this case report is to demonstrate that the pericardial cysts can be missed in chest radiographs and impression of cysts may cause COPD like symptoms in these patients.

  9. Acute direct inguinal hernia resulting from blunt abdominal trauma: Case Report

    OpenAIRE

    Hipkins Gabrielle; Vedanayagam Maria; Biswas Seema; Leather Andrew

    2010-01-01

    Abstract We report a case of traumatic inguinal hernia following blunt abdominal trauma after a road traffic accident and describe the circumstances and technique of repair. The patient suffered multiple upper limb fractures and developed acute swelling of the right groin and scrotum. CT scan confirmed the acute formation of a traumatic inguinal hernia. Surgical repair was deferred until resolution of the acute swelling and subcutaneous haematoma. The indication for surgery was the potential ...

  10. Intrathoracic Kidney after Blunt Abdominal Trauma: A Case Report and Review of the Literature

    OpenAIRE

    Fikret Halis; Akin Soner Amasyali; Aysel Yucak; Turan Yildiz; Ahmet Gokce

    2015-01-01

    Abdominal trauma is responsible for most genitourinary injuries. The incidence of renal artery injury and intrathoracic kidney is quite low in patients who present with blunt trauma experiencing damage. There are four defined etiologies for intrathoracic kidney, which include real intrathoracic ectopic kidney, eventration of the diaphragm, congenital diaphragmatic herniation, and traumatic diaphragmatic rupture. The traumatic intrathoracic kidney is an extremely rare case. We presented intrat...

  11. Pericardial disease and myocarditis: management guide

    International Nuclear Information System (INIS)

    Pericardium is a structure that can be primarily affected by a series of different agents and in a secondary way by systemic processes. Its response is not specific and in general it corresponds to an inflammatory process that can be acute, chronic or recurrent. The recognition of these pathologies is of vital significance in the making of a right therapeutic approach. Some basic orientations for the correct classification, diagnosis and therapy of main pericardial syndromes, based on clinical and etiological aspects and para clinical available aids are presented. Likewise, some recommendations for the specific treatment of each one of the main entities usually affecting the pericardium are given. Next, a brief mention of some pathophysiological aspects of acute myocarditis, its main etiologies, and the treatment of the cardiac failure secondary to the disease with its specific differences, is made, and the controversy on its handling with immuno suppressors and the experimental therapy measures are studied in depth

  12. Giant Pericardial Cyst: A Case Report and Review of Literature

    Directory of Open Access Journals (Sweden)

    Hekmat

    2015-11-01

    Full Text Available Pericardial cysts are rare lesions. These benign anomalies are located in the middle mediastinum. In this article, we present a 24-year-old man who was referred to the emergency department with dyspnea and persistent cough. In physical exam, no abnormality was found. His past medical history was normal. His trans-thoracic echocardiogram showed an echo-lucent space next to the right atrium at the right cardiophrenic angle. No pericardial effusion was found. The patient underwent surgery. After midsternotomy, a huge cyst measuring approximately 13 × 8 × 5 cm in diameters was found on the right side and outside the pericardium that was totally excised. After 5 days, the patient was discharged and pathologic report confirmed preoperative diagnosis of pericardial cyst. Giant pericardial cysts are not common and in this report, we will review published case reports.

  13. CT and MRI of pericardial and cardiac neoplastic disease

    OpenAIRE

    van Beek, Edwin JR; Stolpen, Alan H.; Khanna, Geetika; Thompson, Brad H

    2007-01-01

    This article reviews the pathological classification of cardiac and pericardial neoplasms, the incidence of the various tumor types, and the role of CT and MRI, including their major differences and clinical impact on patient management.

  14. Kocher-debre-semelaigne syndrome with pericardial effusion

    Directory of Open Access Journals (Sweden)

    Dharaskar Praveen

    2007-09-01

    Full Text Available We report a 10-year-old female child with hypothyroidism and limb muscle pseudohypertrophy (i.e., Kocher-Debre-Semelaigne syndrome with pericardial effusion. The child presented with generalized swelling, breathlessness and difficulty in walking and in getting up from sitting position (of chronic duration. She had bradycardia, dull facies, marked hypertrophy of both calf muscles and nonpitting edema of legs. Pericardial effusion was detected clinically and confirmed on investigations. Muscle pseudohypertrophy was a striking feature, and hypothyroidism was confirmed on thyroid studies. The response to thyroxine replacement was excellent, with resolution of the pericardial effusion and clinical improvement. The unusual presence of pericardial effusion in Kocher-Debre-Semelaigne syndrome is discussed in the report.

  15. Methotrexate-induced pericarditis and pericardial effusion; first reported case.

    OpenAIRE

    Forbat, L N; Hancock, B W; Gershlick, A H

    1995-01-01

    We report a case of methotrexate-induced pericarditis and pericardial effusion in a 22-year-old pregnant woman. These complications have not previously been described as isolated phenomena associated with methotrexate therapy.

  16. [Massive pericardial effusion as initial manifestation of hypothyroidism].

    Science.gov (United States)

    Thirone, Ana Cláudia Pelegrinelli; Danieli, Rafael Vinícius; Ribeiro, Vanessa Marajó Fernandes Corrêa

    2012-08-01

    The aim of this study is to report a rare case of massive pericardial effusion as initial manifestation of hypothyroidism. A previously healthy 21-year-old female patient suddenly began presenting dyspnea at rest and lower limb edema. Routine laboratory tests performed at admission showed hypothyroidism (TSH 146.14 mUI/L) and echocardiography showed significant pericardial effusion. Therapy was instituted with levothyroxine, resulting in clinical improvement without pericardiocentesis. The patient was followed up for 1 year, with total remission of dyspnea and edema. However, she developed typical symptoms of hypothyroidism, and remained with asthenia, dyslipidemia, weight gain, and mild pericardial effusion at the end of one year, even with the optimization of the levothyroxine dose. This case highlights the need for early investigation of hypothyroidism in patients with pericardial effusion. PMID:22990643

  17. Neonatal pericardial effusion associated with central eventration of the diaphragm

    OpenAIRE

    Iliff, P J; Eyre, J A; Westaby, S; de Leval, M; Sousa, C

    1983-01-01

    A normal infant born at term developed tachypnoea. A massive pericardial effusion associated with absent central tendon of the diaphragm and eventration into the pericardium was found. Surgical correction was performed and the baby is now well and developing normally.

  18. Hydrothorax, hydromediastinum and pericardial effusion: a complication of intravenous alimentation.

    OpenAIRE

    Damtew, B.; Lewandowski, B

    1984-01-01

    Complications secondary to intravenous alimentation are rare but potentially lethal. Massive bilateral pleural effusions and a pericardial effusion developed in a patient receiving prolonged intravenous alimentation. Severe respiratory distress and renal failure ensued. He recovered with appropriate treatment.

  19. Kocher-debre-semelaigne syndrome with pericardial effusion

    OpenAIRE

    Dharaskar Praveen; Tullu Milind; Lahiri Keya; Kondekar Santosh; Vaswani Rajwanti

    2007-01-01

    We report a 10-year-old female child with hypothyroidism and limb muscle pseudohypertrophy (i.e., Kocher-Debre-Semelaigne syndrome) with pericardial effusion. The child presented with generalized swelling, breathlessness and difficulty in walking and in getting up from sitting position (of chronic duration). She had bradycardia, dull facies, marked hypertrophy of both calf muscles and nonpitting edema of legs. Pericardial effusion was detected clinically and confirmed on investigations. Muscl...

  20. COMPLETE LEFT MAIN BRONCHUS DISRUPTION DUE TO BLUNT CHEST TRAUMA

    Directory of Open Access Journals (Sweden)

    Mohammed Nasser Aldahmashi

    2014-12-01

    Full Text Available Isolated tracheobronchial disruption is an uncommon injury usually associated with severe blunt thoracic trauma. We report a 14 year-old female case with avulsion of the left main bronchus occurring after blunt chest trauma due to a down fallen wall. A successful surgical repair of the totally avulsed left main bronchus was carried out. The postoperative course was uneventful with improvement in the respiratory status. The patient regained wellness within days in the intensive care unit, and the diagnosis of traumatic rupture of the left main bronchus was approved by bonchoscopy and the computerized tomography (CT scan of the chest. Surgical repair of the disrupted left main bronchus was accomplished 10 days from the admission and the bronchoscopic evaluation of the anastomosis and patency was achieved. The patient was discharged with her lung fully expanded on chest X-ray. The diagnosis and preoperative management of this uncommon post traumatic condition is discussed. We conclude that, in a patient with sustained severe blunt thoracic trauma, a high index of suspicion for trachea-bronchial disruptions must be maintained to detect these rare lesions. Skilful and early surgical treatment is required for proper management of such cases.

  1. James Blunt matuselaulude edetabeli tipus

    Index Scriptorium Estoniae

    2006-01-01

    Bereavement Registeri andmetel Suurbritannias matustel tellitavate laulude edetabelis: James Blunt "Goodbye My Lover", Robbie Williams "Angels", Jennifer Warnes ja Bill Medley "I've Had the Time Of My Life", Elton John "Candle in the Wind", Righteous Brothers "Unchained Melody"

  2. Primary Pericardial Mesothelioma: Report of a Patient and Literature Review

    Directory of Open Access Journals (Sweden)

    Åse Nilsson

    2009-07-01

    Full Text Available Primary mesothelioma of the pericardium is a rare tumor and carries a dismal prognosis. This case report presents a 38-year-old man who suffered from recurrent pericardial fluid. Initial symptoms were unspecific, with dry cough and progressing fatigue. Pericardiocentesis was performed, but analyses for malignant cells and tuberculosis were negative. After recurrence a pericardiectomy was planned. At operation, partial resection of tumor tissue surrounding the heart was performed. Histopathologic examination including immunohistochemical staining for calretinin showed a biphasic mesothelioma. During the postoperative period the patient’s condition ameliorated, but symptoms recurred and the patient died 3 months after diagnosis and 15 months after the first symptoms. At autopsy, the pericardium was transformed by the tumor that also expanded into the mediastinum and had set metastases to the liver. A review of 29 cases presented in the recent literature indicates a higher incidence of malignant pericardial mesothelioma among men than women. Median age was 46 (range, 19–76 years. In pleural mesotheliomas, exposure to asbestos is a known risk factor. However, in primary pericardial mesotheliomas the evidence for asbestos as an etiologic factor seems to be less convincing (3 exposed among 14 cases. Symptoms are often unspecific and cytologic examination of pericardial fluid is seldom conclusive (malignant cells demonstrated in 4/17 cases. Partial resection of the tumor can give a period of symptom reduction. Only a few patients have been treated with chemotherapy. Median survival of patients with pericardial mesotheliomas is approximately 6 months.

  3. [Traumatic Injury of the Diaphragm].

    Science.gov (United States)

    Kadokura, Mitsutaka

    2015-07-01

    Traumatic diaphragmatic injury (TDI) is relatively rare condition, and is associated with high rates of morbidity and mortality. TDI usually results from blunt trauma and penetrating trauma. The majority causes of blunt TDI are victims of motor vehicle accidents. The incidence rates of TDI is unknown because of it can be overlooked if it is unsuspected with non-specific radiological and clinical findings. The mortality rates associated with blunt and penetrating TDI are affected by the severity of concurrent organ injuries. The diagnoses of TDI are frequently missed in the post-traumatic assessment because of non-specific symptoms or physical findings. When the site of trauma is in the abdomen, there will be high rate of an intra-abdominal organ injury. Furthermore, when the site of trauma is in the chest, there will be the abdominal organ injury in 50%.Surgical operation should be performed as soon as possible for concomitant injuries. Diaphragmatic repair can be performed using laparotomy, thoracotomy, or both approaches. Primary suture of the diaphragm can be performed in the majority of TDI patients. The outcome of post TDI depends on concurrent organ injury. In case of emergency, it is important to take an appropriate diagnosis and treatment for any concomitant injuries. PMID:26197916

  4. Cerebral Ischemia Due to Traumatic Carotid Artery Dissection: Case Report

    Directory of Open Access Journals (Sweden)

    Deniz Kamacı Şener

    2012-12-01

    Full Text Available Blunt injury to the neck region may lead to carotid artery dissection and cerebral ischemia. Blunt injury to carotid artery is not frequent but determination of the presence of trauma in the history of stroke patients will provide early diagnosis and treatment of them. In this article, a case with cerebral ischemia resulting from traumatic carotid artery dissection is presented and clinical findings, diagnostic procedures and choice of treatment are discussed in the light of the literature.

  5. The Freedom SOLO bovine pericardial stentless valve

    Directory of Open Access Journals (Sweden)

    Stanger O

    2014-12-01

    Full Text Available Olaf Stanger, Hendrik Tevaearai, Thierry Carrel Clinic for Cardiovascular Surgery, University Hospital Berne, Switzerland Abstract: The third-generation bovine pericardium Freedom SOLO (FS stentless valve emerged in 2004 as a modified version of the Pericarbon Freedom stentless valve and as a very attractive alternative to stented bioprostheses. The design, choice of tissue, and anticalcification treatment fulfill most, if not all, requirements for an ideal valve substitute. The FS combines the single-suture, subcoronary implantation technique with the latest-generation bovine pericardial tissue and novel anticalcification treatment. The design allows imitation of the native healthy valve through unrestricted adaption to the patient's anatomy, reproducing a normal valve/root complex. However, despite hemodynamic performance superior to stented valves, we are approaching a critical observation period as superior durability, freedom from structural valve deterioration, and nonstructural failure has not been proven as expected. However, optimal performance and freedom from structural valve deterioration depend on correct sizing and perfect symmetric implantation, to ensure low leaflet stress. Any malpositioning can lead to tissue fatigue over time. Furthermore, the potential for better outcomes depends on optimal patient selection and observance of the limitations for the use of stentless valves, particularly for the FS. Clearly, stentless valve implantation techniques are less reproducible and standardized, and require surgeon-dependent experience and skill. Regardless of whether or not stentless valve durability surpasses third-generation stented bioprostheses, they will continue to play a role in the surgical repertoire. This review intends to help practitioners avoid pitfalls, observe limitations, and improve patient selection for optimal long-term outcome with the attractive FS stentless valve. Keywords: aortic valve, bioprosthesis, cardiac

  6. Imaging of blunt chest trauma

    International Nuclear Information System (INIS)

    Blunt chest trauma is associated with high morbidity and mortality. Consequently, all patients should be evaluated radiologically after blunt chest trauma to allow timely and appropriate treatment. Conventional chest radiographs and computed tomography (CT) are proven modalities with which to evaluate patients after blunt chest trauma. Over the last several years extended focused assessment with sonography for trauma (eFAST) has gained increasing importance for the initial assessment of seriously injured patients. In the acute phase of severely injured patients eFAST examinations are helpful to exclude pneumothorax, hemothorax and hemopericardium. Chest radiographs may also be used to diagnose a pneumothorax or hemothorax; however, the sensitivity is limited and CT is the diagnostic modality of choice to evaluate severely injured patients. (orig.)

  7. Blunt Chest Trauma in Mice after Cigarette Smoke-Exposure: Effects of Mechanical Ventilation with 100 % O2

    OpenAIRE

    Wagner, Katja; Gröger, Michael; McCook, Oscar; Scheuerle, Angelika; Asfar, Pierre; Stahl, Bettina; Huber-Lang, Markus; Ignatius, Anita; Jung, Birgit; Duechs, Matthias; Möller, Peter; Georgieff, Michael; Calzia, Enrico; Radermacher, Peter; Wagner, Florian

    2015-01-01

    Cigarette smoking (CS) aggravates post-traumatic acute lung injury and increases ventilator-induced lung injury due to more severe tissue inflammation and apoptosis. Hyper-inflammation after chest trauma is due to the physical damage, the drop in alveolar PO2, and the consecutive hypoxemia and tissue hypoxia. Therefore, we tested the hypotheses that 1) CS exposure prior to blunt chest trauma causes more severe post-traumatic inflammation and thereby aggravates lung injury, and that 2) hyperox...

  8. Blunt renal trauma in children with pre-existing renal abnormalities.

    Science.gov (United States)

    Dahlstrom, Kelly; Dunoski, Brian; Zerin, Jeffrey Michael

    2015-01-01

    The kidneys are the most commonly injured genitourinary organ in children following blunt abdominal trauma. Though the retroperitoneal location affords the kidneys some protection from the forces experienced in blunt abdominal trauma, the kidneys are at greater risk of injury when a disease process exposes them from their normal shielded location. In such cases, the injuries may appear to be disproportionate in relation to the severity of the trauma history, confusing the imaging findings. Recognition of both the underlying disease process as well as the manifestations of acute trauma is important; therefore, we present a pictorial essay of traumatized kidneys in children with pre-existing renal abnormalities. PMID:25552392

  9. Pediatric blunt splenic trauma: a comprehensive review

    Energy Technology Data Exchange (ETDEWEB)

    Lynn, Karen N.; Werder, Gabriel M.; Callaghan, Rachel M.; Jafri, Zafar H. [William Beaumont Hospital, Department of Diagnostic Radiology, Royal Oak, MI (United States); Sullivan, Ashley N. [St. George' s University School of Medicine, Grenada, West Indies (Grenada); Bloom, David A. [William Beaumont Hospital, Department of Diagnostic Radiology, Royal Oak, MI (United States); William Beaumont Hospital, Section of Pediatric Radiology, Department of Radiology, Royal Oak, MI (United States)

    2009-09-15

    Abdominal trauma is a leading cause of death in children older than 1 year of age. The spleen is the most common organ injured following blunt abdominal trauma. Pediatric trauma patients present unique clinical challenges as compared to adults, including different mechanisms of injury, physiologic responses, and indications for operative versus nonoperative management. Splenic salvage techniques and nonoperative approaches are preferred to splenectomy in order to decrease perioperative risks, transfusion needs, duration/cost of hospitalization, and risk of overwhelming postsplenectomy infection. Early and accurate detection of splenic injury is critical in both adults and children; however, while imaging findings guide management in adults, hemodynamic stability is the primary determinant in pediatric patients. After initial diagnosis, the primary role of imaging in pediatric patients is to determine the level and duration of care. We present a comprehensive literature review regarding the mechanism of injury, imaging, management, and complications of traumatic splenic injury in pediatric patients. Multiple patients are presented with an emphasis on the American Association for the Surgery of Trauma organ injury grading system. Clinical practice guidelines from the American Pediatric Surgical Association are discussed and compared with our experience at a large community hospital, with recommendations for future practice guidelines. (orig.)

  10. Pericardial effusion in a diabetic patient with prostatic abscess

    International Nuclear Information System (INIS)

    Purulent pericarditis is a rare and potentially fatal disease. Its diagnosis and treatment is difficult. An aggressive antibiotic treatment and pericardial drainage are essentials for the treatment of purulent pericarditis. We report an unusual case of a diabetic patient with purulent pericarditis and prostatic abscess with good evolution after appropriate treatment. (author)

  11. Purulent Pericarditis with Greenish Pericardial Effusion Caused by Shewanella algae▿

    OpenAIRE

    Tan, Che-Kim; Lai, Chih-Cheng; Kuar, Wei-Khie; Hsueh, Po-Ren

    2008-01-01

    We report the first case of purulent pericarditis with greenish pericardial effusion caused by Shewanella algae in a patient with gastric and gallbladder cancer. This case expands the reported spectrum of infection caused by S. algae and raises the possibility that S. algae is a causative pathogen for purulent pericarditis.

  12. Treating traumatic injuries of the diaphragm

    Directory of Open Access Journals (Sweden)

    Dwivedi Sankalp

    2010-01-01

    Full Text Available Traumatic diaphragmatic injury (DI is a unique clinical entity that is usually occult and can easily be missed. Their delayed presentation can be due to the delayed rupture of the diaphragm or delayed detection of diaphragmatic rupture, making the accurate diagnosis of DI challenging to the trauma surgeons. An emergency laparotomy and thorough exploration followed by the repair of the defect is the gold standard for the management of these cases. We report a case of blunt DI in an elderly gentleman and present a comprehensive overview for the management of traumatic injuries of the diaphragm.

  13. Traumatic pseudophacocele.

    Directory of Open Access Journals (Sweden)

    Mandal Anil

    2003-01-01

    Full Text Available Post-traumatic subconjunctival dislocation of an intraocular lens (pseudophacocele is a rare but serious complication following cataract surgery. All the previously reported cases were managed by removal of the IOL rendering the eye aphakic. We report a case of traumatic pseudophacocele which was successfully managed by an IOL exchange.

  14. Iliac Artery and Vein Injury Without Pelvic Fracture Due To Blunt Trauma: A Rare Case

    Directory of Open Access Journals (Sweden)

    Mustafa Cuneyt Cicek

    2014-08-01

    Full Text Available Iliac vascular injuries have high morbidity and mortality rates. Penetrant abdominal and pelvic vascular injuries are more common compared to blunt traumas. Pelvic vascular injuries associated with blunt trauma are quite likely to occur in accompaniment with pelvic fracture. A 23 year old male patient was admitted to the emergency room due to a motorcycle accident. Shock picture was prevalent in the patient. Shaft fracture was present in left femur and flow was not detected in arterial and venous colour Doppler ultrasonography. Patient underwent emergency surgery. Left main iliac artery and vein were normal, however, external iliac vein was lacerated in two spots, and blood vessel wall integrity was damaged in one part of left external iliac artery. Clinical presentation and traumatic retroperitoneal hematoma management of iliac artery and venous injuries due to blunt trauma without pelvic fracture are discussed in the presented case.

  15. Sonography of blunt abdominal trauma

    International Nuclear Information System (INIS)

    Sonographic examination of the abdomen after blunt abdominal trauma represents a rapid and effective diagnostic method without bothering the patient. It has proved its value not only in the confirmation or exclusion of free fluid in the abdomen caused by liver of spleen rupture, but also in such cases actually it replaces peritoneal lavage or exploratory laparotomy. It is also qualified for diagnosis of intraparenchymal or subcapsular hemorrhages, intraperitoneal as well as retroperitoneal and for follow up. In particualr delayed bleedings including the risk of a retarded organ rupture can be detected early. A failure rate of 1.4% in 282 sonographically examined cases of blunt abdominal trauma further confirms the reliability of this method. (orig.)

  16. Hyphema as a Complication of Blunt Ocular Trauma and Additional Ocular Findings

    OpenAIRE

    Mehmet Giray Ersöz; Seda Adıyeke; Gamze Türe; Ekrem Talay; Hakkı Özgür Konya

    2014-01-01

    Objectives: To investigate the frequency of angle recession, commotio retinae, and other ocular findings in patients with hyphema due to blunt ocular trauma. Materials and Methods: The medical records of 66 patients hospitalized between July 2010 and May 2012 with a diagnosis of traumatic hyphema were retrospectively reviewed. The age, gender, period between injury and the first examination, visual acuity at presentation, intraocular pressure (IOP), time of disappearance of hyphem...

  17. Cardiovascular magnetic resonance of myocardial infarction after blunt chest trauma: a heartbreaking soccer-shot

    OpenAIRE

    Fogarassy Peter; Maunz Martin; Beck Torsten; Baccouche Hannibal; Beyer Martin

    2009-01-01

    Abstract Cardiac injury occasionally occurs as a result of blunt chest trauma. Most cardiac complications in chest trauma are due to myocardial contusion rather than direct damage to the coronary arteries. However, traumatic coronary injury has been reported, and a variety of underlying pathophysiological mechanisms have been proposed. We present a 26 year old patient presenting with an acute coronary syndrome as a consequence of a soccer-shot impact to the chest. CMR showed apical inferior i...

  18. Imaging of blunt cerebrovascular injuries

    Energy Technology Data Exchange (ETDEWEB)

    Nunez, Diego B. [Department of Radiology, Hospital of St. Raphael, Yale University School of Medicine, 1450 Chapel St., New Haven, CT 06511 (United States)]. E-mail: dnunez@srhs.org; Berkmen, Turgut [Department of Radiology, Hospital of St. Raphael, Yale University School of Medicine, 1450 Chapel St., New Haven, CT 06511 (United States)

    2006-09-15

    Arterial dissection, pseudoaneurysm, arteriovenous fistula, arterial laceration and occlusion are uncommon complications of blunt trauma. Angiography has been considered the primary method of evaluation to assess for vascular injuries but, due to the low frequency of these lesions, its screening role has been challenged. Non-invasive imaging, particularly CT angiography (CTA), offers definitive advantages and has emerged as a promising diagnostic screening method. Angiography is shifting to a rather therapeutic role and the endovascular management of these lesions is briefly discussed.

  19. CT of abdominal blunt trauma

    International Nuclear Information System (INIS)

    We studied CT findings and interventional radiology including therapeutic procedures in 43 cases with abdominal blunt trauma, retrospectively. All of parenchymal organ's injuries, and injuries of duodenum and retroperitoneum were correctly diagnosed by CT. In 14 cases with only hemoperitoneum or no positive findings on CT, 4 cases were jejunal perforations, and remaining 10 cases were conservatively treated and relieved. We have to take care that the similar CT findings include the opposite results to need surgery and not. (author)

  20. Imaging of blunt chest trauma

    International Nuclear Information System (INIS)

    In western European countries most blunt chest traumas are associated with motor vehicle and sport-related accidents. In Switzerland, 39 of 10,000 inhabitants were involved and severely injured in road accidents in 1998. Fifty two percent of them suffered from blunt chest trauma. According to the Swiss Federal Office of Statistics, traumas represented in men the fourth major cause of death (4 %) after cardiovascular disease (38 %), cancer (28 %), and respiratory disease (7 %) in 1998. The outcome of chest trauma patients is determined mainly by the severity of the lesions, the prompt appropriate treatment delivered on the scene of the accident, the time needed to transport the patient to a trauma center, and the immediate recognition of the lesions by a trained emergency team. Other determining factors include age as well as coexisting cardiac, pulmonary, and renal diseases. Our purpose was to review the wide spectrum of pathologies related to blunt chest trauma involving the chest wall, pleura, lungs, trachea and bronchi, aorta, aortic arch vessels, and diaphragm. A particular focus on the diagnostic impact of CT is demonstrated. (orig.)

  1. Imaging of blunt chest trauma

    Energy Technology Data Exchange (ETDEWEB)

    Wicky, S.; Wintermark, M.; Schnyder, P.; Capasso, P.; Denys, A. [Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland). Dept. of Radiology

    2000-10-01

    In western European countries most blunt chest traumas are associated with motor vehicle and sport-related accidents. In Switzerland, 39 of 10,000 inhabitants were involved and severely injured in road accidents in 1998. Fifty two percent of them suffered from blunt chest trauma. According to the Swiss Federal Office of Statistics, traumas represented in men the fourth major cause of death (4 %) after cardiovascular disease (38 %), cancer (28 %), and respiratory disease (7 %) in 1998. The outcome of chest trauma patients is determined mainly by the severity of the lesions, the prompt appropriate treatment delivered on the scene of the accident, the time needed to transport the patient to a trauma center, and the immediate recognition of the lesions by a trained emergency team. Other determining factors include age as well as coexisting cardiac, pulmonary, and renal diseases. Our purpose was to review the wide spectrum of pathologies related to blunt chest trauma involving the chest wall, pleura, lungs, trachea and bronchi, aorta, aortic arch vessels, and diaphragm. A particular focus on the diagnostic impact of CT is demonstrated. (orig.)

  2. Amputation - traumatic

    Science.gov (United States)

    Traumatic amputation is the loss of a body part -- usually a finger, toe, arm, or leg -- that occurs as ... If an accident or trauma results in complete amputation (the body part is totally severed), the part ...

  3. The role of bedside ultrasound in the diagnosis of pericardial effusion and cardiac tamponade

    Directory of Open Access Journals (Sweden)

    Adam Goodman

    2012-01-01

    Full Text Available This review article discusses two clinical cases of patients presenting to the emergency department with pericardial effusions. The role of bedside ultrasound in the detection of pericardial effusions is investigated, with special attention to the specific ultrasound features of cardiac tamponade. Through this review, clinicians caring for patients with pericardial effusions will learn to rapidly diagnose this condition directly at the bedside. Clinicians will also learn to differentiate between simple pericardial effusions in contrast to more complicated effusions causing cardiac tamponade. Indications for emergency pericardiocentesis are covered, so that clinicians can rapidly determine which group of patients will benefit from an emergency procedure to drain the effusion.

  4. Experimental evaluation of technetium-99m red blood cell radionuclide ventriculography for detecting pericardial bleeding

    International Nuclear Information System (INIS)

    Abnormal loculated or diffuse blood pools adjacent to the heart have been observed in patients with pericardial bleeding who have been imaged by gated equilibrium radionuclide ventriculography (RNV). To study the scintigraphic appearance of fresh pericardial blood, we performed equilibrium RNV in six dogs with measured volumes (10, 30, or 50 ml) of intrapericardial blood. Loculated and diffuse pericardial blood was simulated by injecting the blood either into an intrapericardial balloon, or freely into the pericardial space. Ability to detect pericardial blood was determined by blinded review, and blood volume analysis was attempted by measuring its scintigraphic thickness, brightness (relative to the left ventricle), extent, and background-subtracted count rate and a peak count index. Detection rates for 10, 30, and 50 ml were all 100% for loculated pericardial blood, and 67%, 100% and 100% for free pericardial blood, with the use of three scintigraphic views. Visually determined extent of the abnormal blood pool was the most reliable indicator of pericardial blood volume. When the volume was 30 ml or more, at least 40% of the heart was surrounded in 26 of 27 cases (96%); the specificity of this finding was 90%. We conclude from this animal study that RNV should be a sensitive method for detecting pericardial bleeding; visual appearance permits qualitative assessment of the volume of accumulated labeled blood

  5. Blunt indentation of core graphite

    International Nuclear Information System (INIS)

    Blunt indentation experiments were carried out on unoxidized and thermally oxidised IM1-24 graphite as a model to simulate local point stresses acting on graphite moderator bricks. Blunt indentation of unoxidized graphite initiates cracks close to the region of maximum tensile stress at the edge of the indentation. Cracks propagate and converge to form a cone of material. Failure is catastrophic, typically forming three pieces of graphite and ejecting the cone referred to above. The failure mode under indentation loading for highly oxidised graphite (weigh loss > 40%) is different from that for the unoxidized graphite. There is no longer a distinct crack path, the indentation is much deeper than in the case of the unoxidized graphite, and there is a region of crushed debris beneath the indentation, producing a crater-like structure. The reduction in the compressive fracture stress, σcf, under indentation loading with increasing fractional weight loss on oxidation, x, can be fitted to σcf/σ0 = exp-[5.2x] where σ0 is the compressive fracture stress of the unoxidized graphite. This indicates that the effect of thermal oxidation on indentation fracture stress is more severe than the effects of radiolytic oxidation on conventional strengths of nuclear graphites. (author). 8 refs, 12 figs

  6. Autoimmune Pancreatitis with Multiorgan Involvement. A Case of Pericardial Involvement

    Directory of Open Access Journals (Sweden)

    Manu Nayar

    2009-09-01

    Full Text Available Context Autoimmune pancreatitis is increasingly being diagnosed as a multiorgan disorder and a small group of patient present a diagnostic and management dilemma. Case report We report a complicated case of autoimmune pancreatitis with multiorgan involvement. This is the first reported case of pericardial involvement and agrees with other authors that autoimmune pancreatitis is a multisystem disorder predominantly affecting the pancreas. Conclusion In such cases more intensive immunosuppressive therapy may be necessary to get better control of the disease as is apparent from this case.

  7. Successful therapy of coumatetralyl rodenticide induced pericardial effusion with pericardiocentesis in a dog

    OpenAIRE

    Park, Chul; Lim, Chae-Young; Kim, Jung-Hyun; Jang, Jae-Im; Park, Hee-Myung

    2011-01-01

    A 5-year-old, intact male, golden retriever was presented with an acute onset of lethargy and respiratory distress. The dog was diagnosed as having rodenticide intoxication with pericardial effusion. Pericardiocentesis was successfully performed and was followed with a blood transfusion. This case suggests that rodenticide intoxication might cause pericardial effusion in dogs.

  8. Pericardial Effusion with Cardiac Tamponade as a Form of Presentation of Primary Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Acir Rachid

    2002-06-01

    Full Text Available The authors describe a case of pericardial effusion accompanied by cardiac tamponade caused by primary hypothyroidism. Diagnosis was made by exclusion, because other causes of cardiac tamponade are more frequent. Emergency treatment of cardiac tamponade is pericardiocentesis (with possible pericardial window, and, after stabilization, performance of hormonal reposition therapy with L-thyroxin.

  9. Use of PTFE patch for pericardial closure after minimal invasive LVAD implantation.

    Science.gov (United States)

    Mohite, Prashant N; Sabashnikov, Anton; Popov, Aron F; Fatullayev, Javid; Simon, André R

    2016-07-01

    The left ventricular assist device (LVAD) is now a routine therapy for advanced heart failure. The thoracotomy approach for LVAD implantation, in which the left ventricle is approached through a pericardial rent, is becoming popular. We demonstrate closure of the pericardial rent with a polytetrafluoroethylene (PTFE) patch and its advantages. PMID:26519742

  10. Correction of carotid-jugular traumatic fistula using a bovine pericardial patch

    Directory of Open Access Journals (Sweden)

    Werther Souza Sales

    2014-03-01

    Full Text Available Carotid-jugular fistulae are rare, but habitually cause morbidity and mortality. They are often linked with penetrating trauma, primarily caused by gunshots. This report describes the case of a patient who was the victim of a gunshot wound to the left cervical area, provoking a carotid-jugular arteriovenous fistula and occlusion of the common carotid artery. The fistula was corrected by ligature of the internal jugular vein and arteriorrhaphy of the left common carotid artery with a bovine pericardium patch.

  11. Management of blunt hepatic trauma.

    Science.gov (United States)

    Letoublon, C; Amariutei, A; Taton, N; Lacaze, L; Abba, J; Risse, O; Arvieux, C

    2016-08-01

    For the last 20 years, nonoperative management (NOM) of blunt hepatic trauma (BHT) has been the initial policy whenever this is possible (80% of cases), i.e., in all cases where the hemodynamic status does not demand emergency laparotomy. NOM relies upon the coexistence of three highly effective treatment modalities: radiology with contrast-enhanced computerized tomography (CT) and hepatic arterial embolization, intensive care surveillance, and finally delayed surgery (DS). DS is not a failure of NOM management but rather an integral part of the surgical strategy. When imposed by hemodynamic instability, the immediate surgical option has seen its effectiveness transformed by development of the concept of abbreviated (damage control) laparotomy and wide application of the method of perihepatic packing (PHP). The effectiveness of these two conservative and cautious strategies for initial management is evidenced by current experience, but the management of secondary events that may arise with the most severe grades of injury must be both rapid and effective. PMID:27519150

  12. Recurrent Hemorrhagic Pericardial Effusion and Tamponade due to Filariasis Successfully Treated with Ivermectin and Albendazole.

    Science.gov (United States)

    Sinha, Santosh Kumar; Goel, Amit; Sachan, Mohit; Saraf, Sameer; Verma, Chandra Mohan

    2015-01-01

    Filariasis presenting with pericardial effusion with tamponade is rare. We report a case of a 30-year-old female who was admitted with severe dyspnea and chest pain since 2 days. Echocardiogram showed massive pericardial effusion with tamponade. Pericardial fluid aspiration drained 1.2 L of hemorrhagic fluid. Cytology examination revealed microfilaria of Wuchereria bancrofti. She was treated with diethyl carbamazine and discharged. Six weeks later, she presented again with massive pericardial effusion with cardiac tamponade. Pericardiocentesis was done. Cytology examination revealed microfilaria of W. bancrofti. This time she was treated with ivermectin and albendazole and cured. Hemorrhagic effusion resolved completely. Though relatively uncommon, tropical diseases must always be considered in the etiological diagnosis of recurrent pericardial effusion. PMID:26240733

  13. Recurrent hemorrhagic pericardial effusion and tamponade due to filariasis successfully treated with ivermectin and albendazole

    Directory of Open Access Journals (Sweden)

    Santosh Kumar Sinha

    2015-01-01

    Full Text Available Filariasis presenting with pericardial effusion with tamponade is rare. We report a case of a 30-year-old female who was admitted with severe dyspnea and chest pain since 2 days. Echocardiogram showed massive pericardial effusion with tamponade. Pericardial fluid aspiration drained 1.2 L of hemorrhagic fluid. Cytology examination revealed microfilaria of Wuchereria bancrofti. She was treated with diethyl carbamazine and discharged. Six weeks later, she presented again with massive pericardial effusion with cardiac tamponade. Pericardiocentesis was done. Cytology examination revealed microfilaria of W. bancrofti. This time she was treated with ivermectin and albendazole and cured. Hemorrhagic effusion resolved completely. Though relatively uncommon, tropical diseases must always be considered in the etiological diagnosis of recurrent pericardial effusion.

  14. Fatal right coronary artery rupture following blunt chest trauma: detection by postmortem selective coronary angiography.

    Science.gov (United States)

    Inokuchi, Go; Makino, Yohsuke; Motomura, Ayumi; Chiba, Fumiko; Torimitsu, Suguru; Hoshioka, Yumi; Iwase, Hirotaro

    2016-05-01

    Coronary artery injury is a rare complication following blunt chest trauma (BCT), and can be fatal. Here we report findings on postmortem selective coronary angiography of right coronary artery rupture after an assault involving blunt trauma to the chest. A woman in her 60s died after her son stomped on her chest. There were no appreciable signs of injury on external examination, and cause of death could not be determined by postmortem computed tomography (PMCT). Internal findings indicated that an external force had been applied to the anterior chest, as evidenced by subcutaneous hemorrhage and pericardial and cardiac contusions. Postmortem coronary angiography revealed irregularity of the intima and of the fat tissue surrounding the proximal part of the right coronary artery associated with a local filling defect. Histopathological examination suggested coronary rupture with dissection of the tunica media and compression of the lumen cavity. The key points in the present case are that no fatal injuries could be determined on external examination, and the heart and coronary artery injuries were not evident on PMCT. Criminality might be overlooked in such cases, as external investigation at the crime scene would be inadequate and could result in a facile diagnosis of cause of death. This is the first report of coronary artery rupture with dissection that was detected by CT coronary angiography, and provides helpful findings for reaching an appropriate decision both forensically and clinically. PMID:26126482

  15. Late Onset Isolated Traumatic Pneumomediastinum in a Child: A Case Report

    Directory of Open Access Journals (Sweden)

    Ali Kemal Erenler

    2013-04-01

    Full Text Available Pneumomediastinum (PM is defined as the presence of gas or free air in mediastinum. Pneumomediastinum may ocur either by trauma or spontaneously. Traumatic PM is frequently seen after blunt thoracic trauma, head trauma, after endoscopy-bronchoscopy (osephagus perforation, tracheobronchial injury and due to mechanical ventilation. Pneumomediastinum after blunt trauma is a lethal injury that generally occurs in adults with concomittant injuries such as rib fractures, hemo-pneumothorax and thoracic vascular injuries after high-energy traumas. We represent case report of a late onset isolated traumatic PM in a child and aim to underline the difficulty and importance of diagnosis of this lethal injury in the emergency department.

  16. Mechanisms and Clinical Management of Ventricular Arrhythmias following Blunt Chest Trauma

    Directory of Open Access Journals (Sweden)

    Daniel H. Wolbrom

    2016-01-01

    Full Text Available Nonpenetrating, blunt chest trauma is a serious medical condition with varied clinical presentations and implications. This can be the result of a dense projectile during competitive and recreational sports but may also include other etiologies such as motor vehicle accidents or traumatic falls. In this setting, the manifestation of ventricular arrhythmias has been observed both acutely and chronically. This is based on two entirely separate mechanisms and etiologies requiring different treatments. Ventricular fibrillation can occur immediately after chest wall injury (commotio cordis and requires rapid defibrillation. Monomorphic ventricular tachycardia can develop in the chronic stage due to underlying structural heart disease long after blunt chest injury. The associated arrhythmogenic tissue may be complex and provides the necessary substrate to form a reentrant VT circuit. Ventricular tachycardia in the absence of overt structural heart disease appears to be focal in nature with rapid termination during ablation. Regardless of the VT mechanism, patients with recurrent episodes, despite antiarrhythmic medication in the chronic stage following blunt chest injury, are likely to require ablation to achieve VT control. This review article will describe the mechanisms, pathophysiology, and treatment of ventricular arrhythmias that occur in both the acute and chronic stages following blunt chest trauma.

  17. MR imaging findings in 76 consecutive surgically proven cases of pericardial disease with CT and pathologic correlation.

    Science.gov (United States)

    Young, Phillip M; Glockner, James F; Williamson, Eric E; Morris, Michael F; Araoz, Philip A; Julsrud, Paul R; Schaff, Hartzell V; Edwards, William D; Oh, Jae K; Breen, Jerome F

    2012-06-01

    To describe findings of patients with surgically confirmed pericardial disease on state of the art MR sequences. Retrospective review was performed for patients who underwent pericardiectomy and preoperative MR over a 5 year period ending in 2009. Patients' records were reviewed to confirm the diagnosis of chronic recurrent pericarditis, constrictive pericarditis, or pericardial tumor. MR imaging findings of pericardial thickness, IVC diameter, presence or absence of pericardial or pleural effusion, pericardial edema, pericardial enhancement, and septal "bounce" were recorded. Patients with constriction had a larger IVC diameter (3.1 ± 0.4 cm) than patients with recurrent pain and no constriction (2.0 ± 0.4 cm). Mean pericardial thickness for the 16 patients with chronic recurrent pericarditis but no evidence of constriction was 4.8 ± 2.9 mm. Mean pericardial thickness for patients with constriction was 9.2 ± 7.0 cm with calcification, and 4.6 ± 2.1 cm without calcification. 94% of patients with chronic recurrent pericarditis had gadolinium enhancement of the pericardium, while 76% of patients with constriction had pericardial enhancement. Septal "bounce" was present in 19% of chronic recurrent pericarditis cases and 86% of constriction cases. 5 patients had a pericardial neoplasm, 1 of which was not identified preoperatively. State of the art MR techniques can identify significant and distinct findings in patients with chronic recurrent pericarditis, constrictive pericarditis, and pericardial tumors. PMID:21735292

  18. Childhood Traumatic Grief

    Science.gov (United States)

    ... Educators Resources for Kids and Teens Childhood Traumatic Grief What is Childhood Traumatic Grief? Children grieve in their own way following the ... child may have a condition called Childhood Traumatic Grief (CTG). Thinking about the person who died—even ...

  19. Aging May Blunt Some of Exercise's Benefits

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_159438.html Aging May Blunt Some of Exercise's Benefits But, that's ... 17, 2016 FRIDAY, June 17, 2016 (HealthDay News) -- Aging may dampen some beneficial effects of exercise, a ...

  20. Traumatic ureteropelvic disruption in the child

    International Nuclear Information System (INIS)

    Traumatic disruption of the ureter from the renal pelvis is a rare injury because the ureteropelvic junction is situated deep in the retroperitoneum and is thus protected by the spine and paraspinal muscles. The mechanism for this injury is thought to be the stretching of the proximal ureter by sudden extreme hyperextension of the trunk. As a non-fatal injury, this occurs only in the child because of the greater elasticity and mobility of the young skeleton. At The Children's Hospital we have seen 3 cases of avulsion of the ureter from the pelvis following blunt trauma. (orig.)

  1. Late clotted haemothorax after blunt chest trauma.

    OpenAIRE

    Sinha, P; Sarkar, P

    1998-01-01

    A clotted haemothorax can develop any time after blunt chest trauma. Two cases are described in which late clotted haemothoraces developed which were treated by limited thoracotomy and evacuation of clots. Late clotted haemothorax may occur even in the absence of any abnormal initial clinical findings. Early detection and treatment is important to avoid the complications of fibrothorax and empyema with permanent pulmonary dysfunction. After blunt chest trauma patients should be advised to ret...

  2. Successful laparoscopic management of combined traumatic diaphragmatic rupture and abdominal wall hernia: a case report

    OpenAIRE

    Siow, Sze Li; Wong, Chee Ming; Hardin, Mark; Sohail, Mushtaq

    2016-01-01

    Background Traumatic diaphragmatic rupture and traumatic abdominal wall hernia are two well-described but rare clinical entities associated with blunt thoracoabdominal injuries. To the best of our knowledge, the combination of these two clinical entities as a result of a motor vehicle accident has not been previously reported. Case presentation A 32-year-old Indian man was brought to our emergency department after being involved in a road traffic accident. He described a temporary loss of con...

  3. Post-Traumatic Cerebral Infarction Following Low-Energy Penetrating Craniocerebral Injury Caused by a Nail

    OpenAIRE

    Chen, Po-Chuan; Tsai, Shih-Hung; Chen, Yu-Long; Liao, Wen-I

    2014-01-01

    Post-traumatic cerebral infarction (PTCI) is a secondary insult which causes global cerebral hypoxia or hypoperfusion after traumatic brain injury, and carries a remarkable high mortality rate. PTCI is usually caused by blunt brain injury with gross hematoma and/or brain herniation. Herein, we present the case of a 91-year-old male who had sustained PTCI following a low-energy penetrating craniocerebral injury due to a nail without evidence of hematoma. The patient survived after a decompress...

  4. Recurrent hemorrhagic pericardial effusion in a child due to diffuse lymphangiohemangiomatosis: a case report

    Directory of Open Access Journals (Sweden)

    Bakhshi Sameer

    2010-02-01

    Full Text Available Abstract Introduction Recurrent hemorrhagic pericardial effusion in children with no identifiable cause is a rare presentation. Case presentation We report the case of a 4-year-old Indian girl who presented with recurrent hemorrhagic pericardial effusion. Diffuse lymphangiomatosis was suspected when associated pulmonary involvement, soft tissue mediastinal mass, and lytic bone lesions were found. Pericardiectomy and lung biopsy confirmed the diagnosis of diffuse lymphangiohemangiomatosis. Partial clinical improvement occurred with thalidomide and low-dose radiotherapy, but our patient died from progressive respiratory failure. Conclusion Diffuse lymphangiohemangiomatosis should be considered in the differential diagnosis of hemorrhagic pericardial effusion of unclear cause.

  5. Traumatic Endotheliopathy

    DEFF Research Database (Denmark)

    Johansson, Pär I; Henriksen, Hanne; Stensballe, Jakob;

    2016-01-01

    cohorts and animal models but needs confirmation in a large independent patient cohort. METHODS: Prospective observational study of 424 trauma patients admitted to a level 1 Trauma Center. Admission plasma levels of catecholamines (adrenaline, noradrenaline) and biomarkers reflecting endothelial damage...... (syndecan-1, thrombomodulin, and sE-selectin) were measured and demography, injury type and severity, physiology, treatment, and mortality up till 28 days were recorded. RESULTS: Patients had a median ISS of 17 with 72% suffering from blunt injury. Adrenaline and noradrenaline correlated with syndecan-1 (r...... = 0.38, P<0.001 and r = 0.23, P<0.001, respectively) but adrenaline was the only independent predictor of syndecan-1 by multiple linear regression adjusted for age, injury severity score, Glascow Coma Scale, systolic blood pressure, base excess, platelet count, hemoglobin, prehospital plasma, and...

  6. Formation and resolution of bilateral traumatic pulmonary pseudocysts

    International Nuclear Information System (INIS)

    A case of bilateral traumatic pulmonary pseudocysts, an uncommon complication of blunt chest trauma, is presented. The radiologic changes were followed over 6 months until spontaneous resolution had occurred. A computed tomography (CT) was performed, which better demonstrated the presence of a single left-sided cavity with an air/fluid level within a contused area of the upper lobe and a multilocular cavity in the right lower lobe. The mechanism of formation of traumatic pseudocysts and the diagnostic implications are discussed. 10 refs., 5 figs

  7. The role of imaging studies in pancreatic injury due to blunt abdominal trauma in children

    Energy Technology Data Exchange (ETDEWEB)

    Bosboom, D. [Department of Radiology, University Medical Center St Radboud, Postbus 9101, Route 667, 6500 HB Nijmegen (Netherlands); Braam, A.W.E. [Department of Pediatric Surgery, University Medical Center St Radboud, Postbus 9101, Route 815, 6500 HB Nijmegen (Netherlands); Blickman, J.G. [Department of Radiology, University Medical Center St Radboud, Postbus 9101, Route 667, 6500 HB Nijmegen (Netherlands); Wijnen, R.M.H. [Department of Pediatric Surgery, University Medical Center St Radboud, Postbus 9101, Route 815, 6500 HB Nijmegen (Netherlands)]. E-mail: R.Wijnen@kchir.umcn.nl

    2006-07-15

    Background: The role imaging studies play in the choice of treatment in traumatic pancreas damage remains unclear. This study was performed to gain insight into the role of radiological studies in children 16 years of age or younger admitted to our hospital with pancreatic damage due to a blunt abdominal trauma. Method: Retrospectively, the radiological as well as patient clinical records were reviewed of all children admitted to our hospital between 1975 and 2003 with a pancreatic lesion due to blunt abdominal trauma. Results: Thirty-four children with ages ranging from 3 to 14 years old were admitted with traumatic pancreas damage. Initially 33 children were treated conservatively for the pancreatic damage and only one had immediate surgery of the pancreas with a Roux-y pancreaticojejunostomy. Five other children had immediate surgery for other reasons. Overall, five children proved to have a pancreas transection on CT scans or during laparotomy. One child had a pancreas hematoma and 28 a pancreas contusion. In total 15 children developed a pseudocyst (44%), nine of which resolved spontaneously while six were treated by intervention. None of the children had residual morbidity, and there were no deaths. Considering the pancreas, the 11 available CT's were re-evaluated by two radiologists independently. Grade 3 pancreas damage (distal transection of the pancreatic duct) was diagnosed in five patients by radiologist A and four patients by radiologist B (80% match); Grade 1 was diagnosed in, respectively six and one patients (15% match). An US was performed on 19 children with 82 follow-up examinations, mostly for follow-up of the pseudocysts. Conclusion: Traumatic pancreas damage is a rare and difficult diagnosis. There is no straightforward answer for diagnostic imaging in blunt abdominal trauma in children. The diagnostic relevance of CT is limited. CT in combination with MRCP may be a better option for exclusion of pancreatic duct lesions.

  8. The role of imaging studies in pancreatic injury due to blunt abdominal trauma in children

    International Nuclear Information System (INIS)

    Background: The role imaging studies play in the choice of treatment in traumatic pancreas damage remains unclear. This study was performed to gain insight into the role of radiological studies in children 16 years of age or younger admitted to our hospital with pancreatic damage due to a blunt abdominal trauma. Method: Retrospectively, the radiological as well as patient clinical records were reviewed of all children admitted to our hospital between 1975 and 2003 with a pancreatic lesion due to blunt abdominal trauma. Results: Thirty-four children with ages ranging from 3 to 14 years old were admitted with traumatic pancreas damage. Initially 33 children were treated conservatively for the pancreatic damage and only one had immediate surgery of the pancreas with a Roux-y pancreaticojejunostomy. Five other children had immediate surgery for other reasons. Overall, five children proved to have a pancreas transection on CT scans or during laparotomy. One child had a pancreas hematoma and 28 a pancreas contusion. In total 15 children developed a pseudocyst (44%), nine of which resolved spontaneously while six were treated by intervention. None of the children had residual morbidity, and there were no deaths. Considering the pancreas, the 11 available CT's were re-evaluated by two radiologists independently. Grade 3 pancreas damage (distal transection of the pancreatic duct) was diagnosed in five patients by radiologist A and four patients by radiologist B (80% match); Grade 1 was diagnosed in, respectively six and one patients (15% match). An US was performed on 19 children with 82 follow-up examinations, mostly for follow-up of the pseudocysts. Conclusion: Traumatic pancreas damage is a rare and difficult diagnosis. There is no straightforward answer for diagnostic imaging in blunt abdominal trauma in children. The diagnostic relevance of CT is limited. CT in combination with MRCP may be a better option for exclusion of pancreatic duct lesions

  9. Forensic Pathology of Traumatic Brain Injury.

    Science.gov (United States)

    Finnie, J W

    2016-09-01

    Traumatic brain injury constitutes a significant proportion of cases requiring forensic examination, and it encompasses (1) blunt, nonmissile head injury, especially involving motor vehicle accidents, and (2) penetrating, missile injury produced by a range of high- and lower-velocity projectiles. This review examines the complex pathophysiology and biomechanics of both types of neurotrauma and assesses the macroscopic and histologic features of component lesions, which may be used to determine the cause and manner of death resulting from an intentional assault or accident. Estimation of the survival time postinjury by pathologic examination is also important where malicious head injury is suspected, in an attempt to ascertain a time at which the traumatic event might have been committed, thereby evaluating the authenticity of statements made by the alleged perpetrator. PMID:26578643

  10. Traumatic optic neuropathy—Clinical features and management issues

    OpenAIRE

    Yu-Wai-Man, Patrick

    2015-01-01

    Traumatic optic neuropathy (TON) is an uncommon cause of visual loss following blunt or penetrating head trauma, but the consequences can be devastating, especially in cases with bilateral optic nerve involvement. Although the majority of patients are young adult males, about 20% of cases occur during childhood. A diagnosis of TON is usually straightforward based on the clinical history and examination findings indicative of an optic neuropathy. However, the assessment can be difficult when t...

  11. Blunt aortic trauma in a patient with the Ehlers–Danlos syndrome type VI

    Science.gov (United States)

    Yung, Marco Yat Hang; Murray, Jennifer; Thompson, Errington C.

    2016-01-01

    A 24-year-old male with the Ehlers–Danlos syndrome (EDS) type VI (ocular scoliotic) who was kicked in the abdomen presented to the emergency room (ER) with abdominal pain. He was found to have a blunt traumatic aortic injury. The patient was treated nonoperatively. He was stable and discharged home on the eighth day. The patient returned to the ER several days later hypotensive and tachycardic. The patient was taken immediately to the operating room, but vascular repair was not possible. The patient expired. We discuss the challenges of taking care of a patient with EDS and offer suggestions that might improve future patient's outcome. PMID:26956239

  12. Blunt aortic trauma in a patient with the Ehlers-Danlos syndrome type VI.

    Science.gov (United States)

    Yung, Marco Yat Hang; Murray, Jennifer; Thompson, Errington C

    2016-01-01

    A 24-year-old male with the Ehlers-Danlos syndrome (EDS) type VI (ocular scoliotic) who was kicked in the abdomen presented to the emergency room (ER) with abdominal pain. He was found to have a blunt traumatic aortic injury. The patient was treated nonoperatively. He was stable and discharged home on the eighth day. The patient returned to the ER several days later hypotensive and tachycardic. The patient was taken immediately to the operating room, but vascular repair was not possible. The patient expired. We discuss the challenges of taking care of a patient with EDS and offer suggestions that might improve future patient's outcome. PMID:26956239

  13. Management of Pancreatic Injuries after Blunt Abdominal Trauma. Experience at a Single Institution

    Directory of Open Access Journals (Sweden)

    Ker-Kan Tan

    2009-11-01

    Full Text Available Context Pancreatic injuries after blunt abdominal trauma could result in significant morbidity, and even mortality if missed. Objective Our aim was to review our institution’s experience with blunt pancreatic trauma. Setting Our study included all cases of blunt traumatic pancreatic injuries. Patients Sixteen patients (median age 41 years; range: 18-60 years were treated for blunt pancreatic trauma from December 2002 to June 2008. Main outcome measure Pancreatic injuries were graded according to the definition of the American Association for the Surgery of Trauma (AAST. Results CT scans were performed on 10 (62.5% patients, with the remaining 6 (37.5% sent to the operating theatre immediately due to their injuries. Of the 12 (75.0% patients who underwent exploratory laparotomy, 2 (12.5% had a distal pancreatectomy (AAST grade III, 1 (6.3% underwent a Whipple procedure (AAST grade IV while another 2 (12.5% were too hemodynamically unstable for any definitive surgery (AAST grade IV and V; the remaining 7 (43.8% pancreatic injuries were managed conservatively. Four (25.0% patients had their injuries managed non-operatively. Some of the associated complications included intra-abdominal collection (n=2, 12.5% and chest infection (n=2, 12.5%. Conclusion Blunt pancreatic trauma continues to pose significant diagnostic and therapeutic challenges. In view of the numerous associated injuries, priority must be given to stabilizing the patient before any definitive management of the pancreatic injuries is carried out. Mortality in these patients is usually a result of the magnitude of their associated injuries.

  14. False positive stress-test in a patient with pericardial effusion.

    Science.gov (United States)

    Mateja, Candice; Mishkin, Joseph; George, Malika; Chheda, Hemant; Guglin, Maya

    2009-10-01

    We report a case of false positive stress test in a patient with cardiac tamponade. After the drainage of pericardial effusion, reversible defect on a stress test resolved. Cardiac catheterization revealed normal coronary arteries. PMID:18768227

  15. STUDY OF AGE, SEX AND ETIOLOGIC SPECTRUM OF PERICARDIAL EFFUSION IN TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Ravikaladhar Reddy

    2015-10-01

    Full Text Available Pericardial effusion is perhaps one of the most commonly overlooked clinical conditions and definite establishment of etiological agent is not always easy, successful or satisfactory. In this study, 50 cases of pericardial effusion admitted in Medical wards were analysed with emphasis on pattern of age and gender distribution, clinical presentation and et iology. The incidence of pericardial effusion common in age group between 21 - 40 years. The incidence of pericardial effusion is more in males. In the present study, the youngest patient is 15 year old and the oldest is 62 year old. Breathlessness being com monest symptom and raised JVP Is commonest sign. 60% of cases are of tuberculosis etiology, 15% are due to uremia and malignancy each, and 5% due to collagen vascular disease

  16. Symptomatic pericardial schwannoma treated with video-assisted thoracic surgery: a case report

    Science.gov (United States)

    Yun, Po-Jen; Huang, Tsai-Wang; Li, Yao-Feng; Chang, Hung; Lee, Shih-Chun

    2016-01-01

    Intrathoracic schwannomas are neurogenic tumors derived from the Schwann cells of the nerve sheath, most often seen in the posterior mediastinum with anatomical correlations to nerves. Although they are typically benign, a malignant transformation can occur, and thoracotomy instead of video-assisted thoracoscopic surgery (VATS) is required to achieve a complete resection. Only a few cases of pericardial schwannoma have been reported so far. We present a rare case of pericardial schwannoma confirmed by video-assisted thoracoscopic resection. PMID:27162698

  17. Neoinnervation and neovascularization of acellular pericardial-derived scaffolds in myocardial infarcts

    OpenAIRE

    Gálvez-Montón, Carolina; Fernandez-Figueras, M Teresa; Martí, Mercè; Soler-Botija, Carolina; Roura, Santiago; Perea-Gil, Isaac; Prat-Vidal, Cristina; Llucià-Valldeperas, Aida; Raya, Ángel; Bayes-Genis, Antoni

    2015-01-01

    Engineered bioimplants for cardiac repair require functional vascularization and innervation for proper integration with the surrounding myocardium. The aim of this work was to study nerve sprouting and neovascularization in an acellular pericardial-derived scaffold used as a myocardial bioimplant. To this end, 17 swine were submitted to a myocardial infarction followed by implantation of a decellularized human pericardial-derived scaffold. After 30 days, animals were sacrificed and hearts we...

  18. Symptomatic pericardial schwannoma treated with video-assisted thoracic surgery: a case report.

    Science.gov (United States)

    Yun, Po-Jen; Huang, Tsai-Wang; Li, Yao-Feng; Chang, Hung; Lee, Shih-Chun; Kuo, Yen-Liang

    2016-05-01

    Intrathoracic schwannomas are neurogenic tumors derived from the Schwann cells of the nerve sheath, most often seen in the posterior mediastinum with anatomical correlations to nerves. Although they are typically benign, a malignant transformation can occur, and thoracotomy instead of video-assisted thoracoscopic surgery (VATS) is required to achieve a complete resection. Only a few cases of pericardial schwannoma have been reported so far. We present a rare case of pericardial schwannoma confirmed by video-assisted thoracoscopic resection. PMID:27162698

  19. Assessment of pulmonary veins after atrio-pericardial anastomosis by cardiovascular magnetic resonance

    OpenAIRE

    Greenway Steven C; Yoo Shi-Joon; Baliulis Giedrius; Caldarone Christopher; Coles John; Grosse-Wortmann Lars

    2011-01-01

    Abstract Background The atrio-pericardial anastomosis (APA) uses a pericardial pouch to create a large communication between the left atrium and the pulmonary venous contributaries in order to avoid direct suturing of the pulmonary veins during the repair of congenital cardiac malformations. Post-operative imaging is routinely performed by echocardiography but Cardiovascular Magnetic Resonance (CMR) offers excellent anatomical imaging and quantitative information about pulmonary blood flow. W...

  20. Elastin organization in pig and cardiovascular disease patients' pericardial resistance arteries

    DEFF Research Database (Denmark)

    Bloksgaard, Maria; Leurgans, Thomas; Nissen, Inger;

    2015-01-01

    coronary artery bypass grafting or cardiac valve replacement surgeries, can serve as a source of resistance arteries for structural research in cardiovascular disease patients. We applied two-photon excitation fluorescence microscopy to study the parietal pericardium and isolated pericardial resistance...... matrix in resistance arteries from cardiovascular disease patients and propose further use of patient pericardial resistance arteries for studies of the human microvasculature. © 2015 S. Karger AG, Basel....

  1. Procalcitonin and C-reactive protein in pericardial fluid for postmortem diagnosis of sepsis

    OpenAIRE

    Schrag, Bettina; Iglesias, Katia; Mangin, Patrice; Palmiere, Cristian

    2016-01-01

    The aim of this study was to investigate the presence and concentrations of procalcitonin and C-reactive protein in pericardial fluid and compare these levels to those found in the postmortem serum obtained from the femoral blood. Two groups were formed, a sepsis-related fatalities group and a control group. Postmortem native CT scans, autopsies, histology, neuropathology and toxicology as well as other postmortem biochemistry investigations were performed in all cases. Pericardial fluid proc...

  2. Diagnosis of pericardial cysts using diffusion weighted magnetic resonance imaging: A case series

    Directory of Open Access Journals (Sweden)

    Mousavi Negareh

    2011-09-01

    Full Text Available Abstract Introduction Congenital pericardial cysts are benign lesions that arise from the pericardium during embryonic development. The diagnosis is based on typical imaging features, but atypical locations and signal magnetic resonance imaging sequences make it difficult to exclude other lesions. Diffusion-weighted magnetic resonance imaging is a novel method that can be used to differentiate tissues based on their restriction to proton diffusion. Its use in differentiating pericardial cysts from other pericardial lesions has not yet been described. Case presentation We present three cases (a 51-year-old Caucasian woman, a 66-year-old Caucasian woman and a 77-year-old Caucasian woman with pericardial cysts evaluated with diffusion-weighted imaging using cardiac magnetic resonance imaging. Each lesion demonstrated a high apparent diffusion coefficient similar to that of free water. Conclusion This case series is the first attempt to investigate the utility of diffusion-weighted magnetic resonance imaging in the assessment of pericardial cysts. Diffusion-weighted imaging may be a useful noninvasive diagnostic tool for pericardial cysts when conventional imaging findings are inconclusive.

  3. Pericardial and vascular pressures and blood flow in the albacore tuna, Thunnus alalunga.

    Science.gov (United States)

    Lai, N C; Graham, J B; Lowell, W R; Laurs, R M

    1987-01-01

    Pericardial, ventricular, and dorsal aortic pressures, and blood flow were measured in tabled, anesthetized albacore tuna, Thunnus alalunga (7.8-10.7 kg) captured at sea off Monterey, California (USA) during August 1985. Mean pericardial pressure was -10.0/-2.6 cm H2O (Systolic/Diastolic, [S/D]) and mean pericardial pulse pressure was 7.5. Heart rate averaged 87 beats per minute. Mean ventricular pressure was 97.0/12.9 cm H2O [S/D] and mean dorsal aortic pressure was 64. High ventricular and dorsal aortic pressures of albacore reflect the perfusion requirement of its metabolically active tissues and compensate for the energy losses resulting from blood flow through the gills to arterial heat exchanger to capillaries and again back to the venous heat exchanger. As in elasmobranchs, the remarkably high pericardial pulse pressure, large pericardial volume, and negative pericardial pressure in the albacore suggest that its pericardium is more rigid than that of most teleosts and thus facilitates cardiac filling. Published cardiac output values for most non-tunas, when corrected for body size differences, are less than the mean weight specific cardiac output of albacore (29.4 ml/kg per min, range 12.9-51.9). PMID:3582589

  4. Hyphema as a Complication of Blunt Ocular Trauma and Additional Ocular Findings

    Directory of Open Access Journals (Sweden)

    Mehmet Giray Ersöz

    2014-01-01

    Full Text Available Objectives: To investigate the frequency of angle recession, commotio retinae, and other ocular findings in patients with hyphema due to blunt ocular trauma. Materials and Methods: The medical records of 66 patients hospitalized between July 2010 and May 2012 with a diagnosis of traumatic hyphema were retrospectively reviewed. The age, gender, period between injury and the first examination, visual acuity at presentation, intraocular pressure (IOP, time of disappearance of hyphema, cause of blunt injury, additional ocular findings, medical and/or surgical treatment, follow-up time, and visual outcome were noted. Results: The mean age of the patients was 23.8±19.2 years. Males constituted the 83.3% of the whole group. Game-related injury (43.9% and work-related injury (22.7% were the most common causes of blunt trauma. The bead gun was the most common tool involved in injury. Angle recession was detected in 36 patients (54.5%. Development of secondary glaucoma was higher in the patients with angle recession (chi-square test, p<0.05. Commotio retinae was observed in 47% of patients. The mean visual acuity at presentation was 0.4±0.3, while at the last visit, it was 0.8±0.3. There was a statistically significant difference between baseline and final visual acuity (paired-samples t-test, p<0.001. Conclusion: Hyphema due to blunt ocular trauma is observed mostly in young men and children. The most common blunt ocular injuries are game-and work-related. Angle recession and commotio retinae are the main complications of blunt ocular trauma causing hyphema. In cases with blunt ocular trauma, the presence of hyphema makes it difficult to examine the anterior chamber angle and the fundus. It is important to perform these investigations at the earliest stage to manage the complications since commotio retinae and angle recession accompany many cases with hyphema. (Turk J Ophthalmol 2014; 44: 19-22

  5. Study of airfoil trailing edge bluntness noise

    DEFF Research Database (Denmark)

    Zhu, Wei Jun; Shen, Wen Zhong; Sørensen, Jens Nørkær

    This paper deals with airfoil trailing edge noise with special focus on airfoils with blunt trailing edges. Two methods are employed to calculate airfoil noise: The flow/acoustic splitting method and the semi-empirical method. The flow/acoustic splitting method is derived from compressible Navier......-Stokes equations. It provides us possibilities to study details about noise generation mechanism. The formulation of the semi-empirical model is based on acoustic analogy and then curve-fitted with experimental data. Due to its high efficiency, such empirical relation is used for purpose of low noise airfoil...... design or optimization. Calculations from both methods are compared with exist experiments. The airfoil blunt noise is found as a function of trailing edge bluntness, Reynolds number, angle of attack, etc....

  6. Cardiogenic shock following blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Rodríguez-González Fayna

    2010-01-01

    Full Text Available Cardiac contusion, usually caused by blunt chest trauma, has been recognized with increased frequency over the past decades. Traffic accidents are the most frequent cause of cardiac contusions resulting from a direct blow to the chest. Other causes of blunt cardiac injury are numerous and include violent fall impacts, interpersonal aggression, explosions, and various types of high-risk sports. Myocardial contusion is difficult to diagnose; clinical presentation varies greatly, ranging from lack of symptoms to cardiogenic shock and arrhythmia. Although death is rare, cardiac contusion can be fatal. We present a case of cardiac contusion due to blunt chest trauma secondary to a fall impact, which manifested as cardiogenic shock.

  7. MR imaging for blunt pancreatic injury

    International Nuclear Information System (INIS)

    Objective: To study the MR imaging features of blunt pancreatic injury. Materials and methods: Nine patients with pancreatic injury related to blunt abdominal trauma confirmed by surgery performed MR imaging. Two abdominal radiologists conducted a review of the MR images to assess pancreatic parenchymal and pancreatic duct injury, and associated complications. Result: Diagnostic quality MR images were obtained in each of the nine patients. In the nine patients, pancreatic fracture, laceration and contusion were depicted on MR imaging in five, one and three patients, respectively. There were six patients with pancreatic duct disruption, eight patients with peripancreatic fluid collections, and four patients with peripancreatic pseudocyst or hematoma, respectively. All of the MR imaging findings was corresponded to surgical findings. Conclusion: MR imaging is an effective method to detect blunt pancreatic injury and may provide information to guide management decisions.

  8. MR imaging for blunt pancreatic injury

    Energy Technology Data Exchange (ETDEWEB)

    Yang Lin [Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000 (China); Zhang Xiaoming, E-mail: cjr.zhxm@vip.163.co [Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000 (China); Xu Xiaoxue; Tang Wei; Xiao Bo; Zeng Nanlin [Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000 (China)

    2010-08-15

    Objective: To study the MR imaging features of blunt pancreatic injury. Materials and methods: Nine patients with pancreatic injury related to blunt abdominal trauma confirmed by surgery performed MR imaging. Two abdominal radiologists conducted a review of the MR images to assess pancreatic parenchymal and pancreatic duct injury, and associated complications. Result: Diagnostic quality MR images were obtained in each of the nine patients. In the nine patients, pancreatic fracture, laceration and contusion were depicted on MR imaging in five, one and three patients, respectively. There were six patients with pancreatic duct disruption, eight patients with peripancreatic fluid collections, and four patients with peripancreatic pseudocyst or hematoma, respectively. All of the MR imaging findings was corresponded to surgical findings. Conclusion: MR imaging is an effective method to detect blunt pancreatic injury and may provide information to guide management decisions.

  9. A Rare and Serious Syndrome That Requires Attention in Emergency Service: Traumatic Asphyxia

    Directory of Open Access Journals (Sweden)

    Gultekin Gulbahar

    2015-01-01

    Full Text Available Traumatic asphyxia is a rare syndrome caused by blunt thoracoabdominal trauma and characterized by cyanosis, edema, and subconjunctival and petechial hemorrhage on the face, neck, upper extremities, and the upper parts of the thorax. Traumatic asphyxia is usually diagnosed by history and inspection; however, the patient should be monitored more closely due to probable complications of thoracoabdominal injuries. Treatment is conservative, but the prognosis depends on the severity of the associated injuries. Herein we present a traumatic asphyxia due to an elevator accident in a 32-year-old male patient and discuss the diagnosis, treatment, and prognosis by reviewing the relevant literature.

  10. Pericardial effusion in patients with cancer: outcome with contemporary management strategies.

    Science.gov (United States)

    Laham, R. J.; Cohen, D. J.; Kuntz, R. E.; Baim, D. S.; Lorell, B. H.; Simons, M.

    1996-01-01

    OBJECTIVE--To investigate the clinical presentation and current management strategies of pericardial effusion in patients with malignancy. DESIGN--Retrospective single centre, consecutive observational study. SETTING--University hospital. PATIENTS--93 consecutive patients with a past or present diagnosis of cancer and a pericardial effusion, including 50 with a pericardial effusion > 1 cm. RESULTS--Of the 50 patients with pericardial effusions > 1 cm, most had stage 4 cancer (64%), were symptomatic at the time of presentation (74%), and had right atrial collapse (74%). Twenty patients were treated conservatively (without pericardiocentesis) and were less symptomatic (55% v 87%, P = 0.012), had smaller pericardial effusions (1.5 (0.4) v 1.8 (0.5), P = 0.02), and less frequent clinical (10% v 40%, P = 0.02) and echocardiographic evidence of tamponade (40% v 97%, P < 0.001) than the 30 patients treated invasively with initial pericardiocentesis (n = 29) or pericardial window placement (n = 1). Pericardial tamponade requiring repeat pericardiocentesis occurred in 18 (62%) of 29 patients after a median of 7 days. In contrast, only four (20%) of 20 patients in the conservative group progressed to frank clinical tamponade and required pericardiocentesis (P = 0.005 v invasive group). The overall median survival was 2 months with a survival rate at 48 months of 26%. Survival, duration of hospital stay, and hospital charges were similar with both strategies. By multivariable analysis, the absence of symptoms was the only independent predictor of long-term survival (relative hazards ratio = 3.2, P = 0.05). Survival was similar in the 43 patients with cancer and pericardial effusions of < or = 1 cm. CONCLUSION--Asymptomatic patients with cancer and pericardial effusion can be managed conservatively with close follow up. In patients with symptoms or clinical cardiac tamponade, pericardiocentesis provides relief of symptoms but does not improve survival and has a high recurrence

  11. Roentgenologic evaluation of blunt abdominal trauma

    International Nuclear Information System (INIS)

    This study comprises 25 cases of blunt abdominal trauma proved by surgery. It is concluded that visceral damage by blunt abdominal trauma may be suspected, but can not be satisfactorily diagnosed upon a single plane abdominal roentgenologic examination with clinical support. Contrary to some reports in the literature, rupture of the hallow, viscus is more susceptible than solid organ and ileum is more than jejunum. It is a useful roentgenologic sign denoting distension and small cresent air shadow in the duodenal sweep of the damaged pancreas

  12. Contemporary management of blunt aortic trauma.

    Science.gov (United States)

    Dubose, J J; Azizzadeh, A; Estrera, A L; Safi, H J

    2015-10-01

    Blunt thoracic aortic injury (BTAI) remains a common cause of death following blunt mechanisms of trauma. Among patients who survive to reach hospital care, significant advances in diagnosis and treatment afford previously unattainable survival. The Society for Vascular Surgery (SVS) guidelines provide current best-evidence suggestions for treatment of BTAI. However, several key areas of controversy regarding optimal BTAI care remain. These include the refinement of selection criteria, timing for treatment and the need for long-term follow-up data. In addition, the advent of the Aortic Trauma Foundation (ATF) represents an important development in collaborative research in this field. PMID:25868973

  13. The Effect of Pre-Injury Anti-Platelet Therapy on the Development of Complications in Isolated Blunt Chest Wall Trauma: A Retrospective Study

    OpenAIRE

    Battle, Ceri; Hutchings, Hayley; Bouamra, Omar; Phillip A Evans

    2014-01-01

    Introduction The difficulties in the management of the blunt chest wall trauma patient in the Emergency Department due to the development of late complications are well recognised in the literature. Pre-injury anti-platelet therapy has been previously investigated as a risk factor for poor outcomes following traumatic head injury, but not in the blunt chest wall trauma patient cohort. The aim of this study was to investigate pre-injury anti-platelet therapy as a risk factor for the developmen...

  14. Strangulated intercostal liver herniation subsequent to blunt trauma. First report with review of the world literature

    Directory of Open Access Journals (Sweden)

    Bendinelli Cino

    2012-07-01

    Full Text Available Abstract Traumatic transdiaphragmatic intercostal hernia, defined as an acquired herniation of abdominal contents through disrupted intercostal muscles, is a rarely reported entity. We present the first reported case of a traumatic transdiaphragmatic intercostal hernia complicated by strangulation of the herniated visceral contents. Following blunt trauma, a 61-year old man developed a traumatic transdiaphragmatic intercostal hernia complicated by strangulation of liver segment VI. Due to pre-existing respiratory problems and the presence of multiple other injuries (grade III kidney laceration and lung contusion the hernia was managed non-operatively for the first 2 weeks. The strangulated liver segment eventually underwent ischemic necrosis. Six weeks later the resulting subcutaneous abscess required surgical drainage. Nine months post injury the large symptomatic intercostal hernia was treated with laparoscopic mesh repair. Twelve months after the initial trauma, a small recurrence of the hernia required laparoscopic re-fixation of the mesh. This paper outlines important steps in managing a rare post traumatic entity. Early liver reduction and hernia repair would have been ideal. The adopted conservative approach caused liver necrosis and required staged procedures to achieve a good outcome.

  15. The effect of posterior pericardiotomy on pericardial effusion and atrial fibrillation after off-pump coronary artery bypass graft.

    OpenAIRE

    Mahdi Haddadzadeh; Mahtab Motavaselian; Ali Akbar Rahimianfar; Seyed Khalil Forouzannia; Mahmood Emami; Kazem Barzegar

    2015-01-01

    The most common type of arrhythmia following coronary artery bypass graft (CABG) is atrial fibrillation (AF) with an incidence rate of 20-30%. Pericardial effusion is one of the etiologic factors of atrial fibrillation occurring after CABG. Posterior pericardiotomy (PP) causes the drainage of blood and fluids from the pericardial space into the pleural space leading to a decreased pericardial effusion. Most of the studies dealing with the occurrence of AF in the surgical operation of CABG hav...

  16. Angiotensin antagonists in the dog with chronic pericardial tamponade

    International Nuclear Information System (INIS)

    Assessing the role played by angiotensin in the pathogenesis and maintenance of the renal function and perfusion abnormalities dogs with chronic pericardial tamponade were used in the experiment as a stable model of chronic low output heart failure. The heptapeptide and octapeptide antagonist were used. The results of the experiments suggest that there is a role for angiotensin in the pathologenesis of congestive heart failure. The renin-angiotensin system was activated in the model. Plasma renin activity was elevated and increased further in response to angiotensin blockade. Under the experiment condition there was no evidence for a role for angiotensin in the maintenance of arterial blood pressure. But there was angiotensin-mediated renal vasoconstriction and a reduction in renal blood flow. Both analogues of angiotensin were able to antagonize this effect in similar fashion. Failure to achieve a natriuresis in response to angiotensin blockade may reflect the redistribution of blood flow that occured and suggests that additional factors are operative in this model. (APR)

  17. Impact of pericardial adhesions on diastolic function as assessed by vortex formation time, a parameter of transmitral flow efficiency

    Directory of Open Access Journals (Sweden)

    Heys Jeffrey J

    2010-09-01

    Full Text Available Abstract Background Pericardial adhesions are a pathophysiological marker of constrictive pericarditis (CP, which impairs cardiac filling by limiting the total cardiac volume compliance and diastolic filling function. We studied diastolic transmitral flow efficiency as a new parameter of filling function in a pericardial adhesion animal model. We hypothesized that vortex formation time (VFT, an index of optimal efficient diastolic transmitral flow, is altered by patchy pericardial-epicardial adhesions. Methods In 8 open-chest pigs, the heart was exposed while preserving the pericardium. We experimentally simulated early pericardial constriction and patchy adhesions by instilling instant glue into the pericardial space and using pericardial-epicardial stitches. We studied left ventricular (LV function and characterized intraventricular blood flow with conventional and Doppler echocardiography at baseline and following the experimental intervention. Results Significant decreases in end-diastolic volume, ejection fraction, stroke volume, and late diastolic filling velocity reflected the effects of the pericardial adhesions. The mean VFT value decreased from 3.61 ± 0.47 to 2.26 ± 0.45 (P = 0.0002. Hemodynamic variables indicated the inhibiting effect of pericardial adhesion on both contraction (decrease in systolic blood pressure and +dP/dt decreased and relaxation (decrease in the magnitude of -dP/dt and prolongation of Tau function. Conclusion Patchy pericardial adhesions not only negatively impact LV mechanical functioning but the decrease of VFT from normal to suboptimal value suggests impairment of transmitral flow efficiency.

  18. Isolated renal pelvis rupture secondary to blunt trauma: Case report

    Directory of Open Access Journals (Sweden)

    Kerem Taken

    2015-01-01

    Conclusion: Renal pelvic injury must be considered in the differential diagnosis of blunt trauma. Surgical intervention may be necessary in some cases. We present a case who underwent surgery due to isolated renal pelvis rupture caused by blunt abdominal trauma.

  19. Perioperative management of tracheobronchial injury following blunt trauma

    Directory of Open Access Journals (Sweden)

    Nilesh M Juvekar

    2013-01-01

    Full Text Available We describe tracheobronchial injury (TBI in a 17-year-old teenager following blunt trauma resulting from a road traffic accident. The patient presented to a peripheral hospital with swelling over the neck and face associated with bilateral pneumothorax for which bilateral intercostal drains were inserted and the patient was transferred to our institute. Fiber-optic videobronchoscopy (FOB was performed, the trachea and bronchi were visualized, and the site and extent of injury was assessed. Spontaneous respiration was maintained till assessment of the airway. Then the patient was anesthetized with propofol and paralyzed using succinylcholine and a double-lumen endobronchial tube was inserted; thereafter, the adequacy of controlled manual ventilation and air-leak through intercostal drains was assessed and the patient was transferred to operating room (OR for repair of the airway injury. The OR was kept ready during FOB to manage any catastrophe. This case describes the need for proper preparation and communication between health care team members to manage all possible scenarios of traumatic TBI.

  20. Diagnosis of an Inguinal Hernia after a Blunt Inguinal Trauma with an Intestinal Perforation

    Science.gov (United States)

    Moustafa, Farès; Avouac, Julien; Vaz, Marie-Aude; Schmidt, Jeannot

    2014-01-01

    Introduction. Inguinal hernias are very common in men. A clinical exam can do the diagnosis easily. But bowel perforation inside an inguinal hernia caused by a directly blunt trauma is rare and can have important consequences. Up to now, there have been a few case reports that described blunt injury to the inguinal area causing traumatic perforation of the bowel in the inguinal hernia. Case Report. We present a case of a 45-year-old Eastern European man with a small perforation of ileal bowels and a peritonitis after direct blunt trauma to the inguinal hernia region, with no inguinal hernia known by the patient, and show how the diagnosis can be difficult. Conclusion. This case shows that external forces, that may seem too trivial to cause intraperitoneal injury, can cause significant injury when applied to a patient with a hernia and shows how a careful examination, with the help of an abdominal CT scan, is important even if the patient do not seem to have an inguinal hernia. PMID:24839569

  1. Radiological management of blunt polytrauma with computed tomography and angiography: an integrated approach

    Energy Technology Data Exchange (ETDEWEB)

    Kurdziel, J.C.; Dondelinger, R.F.; Hemmer, M.

    1987-01-01

    107 polytraumatized patients, who had experienced blunt trauma have been worked up at admission with computed tomography of the thorax, abdomen and pelvis following computed tomography study of the brain: significant lesions were revealed in 98 (90%) patients. 79 (74%) patients showed trauma to the thorax, in 69 (64%) patients abdominal or pelvic trauma was evidenced. No false positive diagnosis was established. 5 traumatic findings were missed. Emergency angiography was indicated in 3 (3%) patients, following computed tomography examination. 3 other trauma patients were submitted directly to angiography without computed tomography examination during the time period this study was completed. Embolization was carried out in 5/6 patients. No thoracotomy was needed. 13 (12%) patients underwent laparotomy following computed tomography. Overall mortality during hospital stay was 14% (15/107). No patient died from visceral bleeding. Conservative management of blunt polytrauma patients can be advocated in almost 90% of visceral lesions. Computed tomography coupled with angiography and embolization represent an adequate integrated approach to the management of blunt polytrauma patients.

  2. Radiological management of blunt polytrauma with computed tomography and angiography: an integrated approach

    International Nuclear Information System (INIS)

    107 polytraumatized patients, who had experienced blunt trauma have been worked up at admission with computed tomography of the thorax, abdomen and pelvis following computed tomography study of the brain: significant lesions were revealed in 98 (90%) patients. 79 (74%) patients showed trauma to the thorax, in 69 (64%) patients abdominal or pelvic trauma was evidenced. No false positive diagnosis was established. 5 traumatic findings were missed. Emergency angiography was indicated in 3 (3%) patients, following computed tomography examination. 3 other trauma patients were submitted directly to angiography without computed tomography examination during the time period this study was completed. Embolization was carried out in 5/6 patients. No thoracotomy was needed. 13 (12%) patients underwent laparotomy following computed tomography. Overall mortality during hospital stay was 14% (15/107). No patient died from visceral bleeding. Conservative management of blunt polytrauma patients can be advocated in almost 90% of visceral lesions. Computed tomography coupled with angiography and embolization represent an adequate integrated approach to the management of blunt polytrauma patients

  3. Acute direct inguinal hernia resulting from blunt abdominal trauma: Case Report

    Directory of Open Access Journals (Sweden)

    Hipkins Gabrielle

    2010-06-01

    Full Text Available Abstract We report a case of traumatic inguinal hernia following blunt abdominal trauma after a road traffic accident and describe the circumstances and technique of repair. The patient suffered multiple upper limb fractures and developed acute swelling of the right groin and scrotum. CT scan confirmed the acute formation of a traumatic inguinal hernia. Surgical repair was deferred until resolution of the acute swelling and subcutaneous haematoma. The indication for surgery was the potential for visceral strangulation or ischaemia with the patient describing discomfort on coughing. At surgery there was complete obliteration of the inguinal canal with bowel and omentum lying immediately beneath the attenuated external oblique aponeurosis. A modified prolene mesh hernia repair was performed after reconstructing the inguinal ligament and canal in layers. To our knowledge, this is the first documented case of the formation of an acute direct inguinal hernia caused as a result of blunt abdominal trauma with complete disruption of the inguinal canal. Surgical repair outlines the principles of restoration of normal anatomy in a patient who is physiologically recovered from the acute trauma and whose anatomy is distorted as a result of his injuries.

  4. CT measurement of normal pericardial thickness in adults on computed tomography

    International Nuclear Information System (INIS)

    The purpose of this study was to establish, using computed tomography, the normal thickness of the pericardium in adults. Materials and Methods: CT scans of 50 patients, including sections through the level of the heart, were reviewed. Patients were excluded if there were any suspicions of pericardial abnormality such as infectious or neoplastic diseases. Twenty-four of the 50 were men and 26 were women; their mean age was 47.0(range,18-76) years. We measured pericardial thickness at the level of the right ventricle, interventricular septum and left ventricle, and also compared pericardial thickness in terms of age and sex. Results: In all patients, the pericardium was observed in the right ventricular region; in 41 (82%) at the interventricular septum; and in 41 (82%) along the left ventricle. The mean thickness of normal pericardium at the level of the right ventricle, interventricular septum, and left ventricle was 1.8 mm ± 0.5 mm, 1.8 mm ± 0.4 mm, and 1.7 mm ± 0.5 mm, respectively. No statistically significant correlation was apparent between pericardial thickness and age group (p > 0.63, ANOVA test). Mean pericardial thickness was 1.9 mm ± 0.6 mm in males and 1.7 mm ± 0.4 mm in females; thus, no statistically significant correlation was apparent between pericardial thickness and sex (p >0.29, Student's t-test). Conclusion: The pericardium was best visualized in sections through the right ventricle.The mean thickness of normal pericardium was 1.8 mm ± 0.5 mm and pericardial thickness did not differ according to age or sex

  5. Computer tomography following blunt abdominal trauma

    International Nuclear Information System (INIS)

    The computer tomographic appearances of lesions of parenchymatous organs following blunt abdominal trauma are described in 13 patients (five liver, four renal, two splenic and two pancreatic injuries). The value of abdominal computer tomography is discussed in relation to the interval between injury and time of abdominal examination and compared with the diagnostic value of abdominal angiography. (orig.)

  6. Cardiac injuries in blunt chest trauma

    OpenAIRE

    Tobon-Gomez Catalina; Huguet Marina; Bijnens Bart H; Frangi Alejandro F; Petit Marius

    2009-01-01

    Abstract Blunt chest traumas are a clinical challenge, both for diagnosis and treatment. The use of Cardiovascular Magnetic Resonance can play a major role in this setting. We present two cases: a 12-year-old boy and 45-year-old man. Late gadolinium enhancement imaging enabled visualization of myocardial damage resulting from the trauma.

  7. Tetanus after blunt lawn mower trauma

    Directory of Open Access Journals (Sweden)

    Camilla Normand

    2015-01-01

    Full Text Available A patient presented with tetanus ten days after blunt trauma with a lawn mower. Our case describes the diagnosis and treatment of this patient with an infectious disease commonly seen in the developing world but rarely seen in the developed world.

  8. Tetanus after blunt lawn mower trauma

    OpenAIRE

    Camilla Normand; Aasmund Fostervold; Elin Haarr; Marie Skontorp; Åse Berg

    2015-01-01

    A patient presented with tetanus ten days after blunt trauma with a lawn mower. Our case describes the diagnosis and treatment of this patient with an infectious disease commonly seen in the developing world but rarely seen in the developed world.

  9. The efficacy and safety of complete pericardial drainage by means of intrapericardial fibrinolysis for the prevention of complications of pericardial effusion: a systematic review protocol

    Science.gov (United States)

    Kakia, Aloysious; Wiysonge, Charles S; Ochodo, Eleanor A; Awotedu, Abolade A; Ristic, Arsen D; Mayosi, Bongani M

    2016-01-01

    Introduction Intrapericardial fibrinolysis has been proposed as a means of preventing complications of pericardial effusion such as cardiac tamponade, persistent and recurrent pericardial effusion, and pericardial constriction. There is a need to understand the efficacy and safety of this procedure because it shows promise. Methods and analysis We aim to assess the effects of intrapericardial fibrinolysis in the treatment of pericardial effusion. We will search PubMed, the Cochrane Library, African Journals online, Cumulative Index to Nursing and Allied Health Literature, Trip database, Clinical trials.gov and the WHO International Clinical Trials Registry Platform for studies that evaluate the efficacy and/or safety of complete pericardial fluid drainage by intrapericardial fibrinolysis irrespective of study design, geographical location, language, age of participants, aetiology of pericarditis or types of fibrinolytics. Two authors will do the search independently, screen the search outputs for potentially eligible studies and assess whether the studies meet the inclusion criteria. Discrepancies between the two authors will be resolved through discussion and arbitration by a third author. Data from the selected studies shall be extracted using a standardised data collection form which will be piloted before use. The methodological quality of studies will be assessed using the Cochrane Collaboration's tools for assessing risk of bias for experimental studies and non-randomised studies, respectively. The primary meta-analysis will use random effects models due to expected interstudy heterogeneity. Dichotomous data will be analysed using relative risk and continuous with data mean differences, both with 95% CIs. Ethics and dissemination Approval by an ethics committee is not required for this study as it is a protocol for a systematic review of published studies. The results will be disseminated through a conference presentation and peer-reviewed publication. Review

  10. Traumatic Infra-renal Aortic Dissection After a High-energy Trauma: A Case Report of a Primary Missed Diagnosis

    OpenAIRE

    Holger Godry; Guido Rölleke; Achim Mumme; Thomas A. Schildhauer; Martin Gothner

    2014-01-01

    A traumatic infra-renal aortic dissection is a rare but life-threatening injury that follows deceleration injuries. The mechanism of blunt abdominal aortic injury involves both direct and indirect forces. The successful management of patients with traumatic injuries depends on a prompt suspicion of the injury and early diagnosis and therapy. Missed injuries in trauma patients are well-described phenomena and implementation of the ATLS® trauma schedule led to a decrease in the number of missed...

  11. [Traumatic dissection of the internal carotid artery by a safety belt: a report of two cases].

    Science.gov (United States)

    López-Sánchez, M; Ballesteros-Sanz, M A; Pérez-Ceballos, A; González-Fernández, C; López-Espadas, F

    2009-10-01

    Traumatic internal carotid artery dissection secondary to blunt trauma is a rare event accounting for 0.08 to 0.4% of all traumatic lesions. The spectrum of traumatic lesions that can affect the internal carotid artery includes minor lesions like spasm, intimal tears, or mural contusions and serious lesions like pseudoaneurysms and complete occlusion. Delayed clinical presentation is typical and can include headache, hemiparesis, partial Horner's syndrome, and cranial nerve palsy. Embolization secondary to the dissection can have devastating effects because it may cause ischemic stroke. Traumatic internal carotid artery dissection after safety belt trauma is very rare; it is usually due to direct cervical trauma on the side of the shoulder fixation point, which causes external bruising along the pathway of the safety belt. We present two cases of traumatic internal carotid artery dissection with concomitant cerebral infarcts caused by safety belts; we discuss the clinical, diagnostic, and therapeutic aspects of this lesion. PMID:19828398

  12. Large pericardial effusions due to systemic lupus erythematosus: a report of eight cases.

    Science.gov (United States)

    Weich, H S v H; Burgess, L J; Reuter, H; Brice, E A; Doubell, A F

    2005-01-01

    The aim of this study was to describe the clinical, echocardiographic and laboratory characteristics of large pericardial effusions and cardiac tamponade secondary to systemic lupus erythematosus (SLE). An ongoing prospective study was conducted at Tygerberg Academic Hospital, South Africa between 1996 and 2002. All patients older than 13 years presenting with large pericardial effusions (> 10 mm) requiring pericardiocentesis were included. Eight cases (out of 258) were diagnosed with SLE. The mean (SD) age was 29.5 (10.7) years. Common clinical features were Raynaud's phenomenon, arthralgia and lupus nephritis class III/IV. Echocardiography showed Libman-Sacks endocarditis (LSE) in all the mitral valves. Two patients developed transient left ventricular dysfunction; both these patients had pancarditis. Typical serological findings included antinuclear antibodies, anti-double stranded DNA antibodies, low complement C4 levels and low C3 levels. CRP was elevated in six cases. Treatment consisted of oral steroids and complete drainage of the pericardial effusions. No repeat pericardial effusions or constrictive pericarditis developed amongst the survivors (3.1 years follow up). This study concludes that large pericardial effusions due to SLE are rare, and associated with nephritis, LSE and myocardial dysfunction. Treatment with steroids and complete drainage is associated with a good cardiac outcome. PMID:16038109

  13. Video-assisted pericardioscopy. How to improve diagnostic efficacy in pericardial effusions

    Directory of Open Access Journals (Sweden)

    Paulo M. Pêgo-Fernandes

    2001-11-01

    Full Text Available OBJECTIVE: To assess, in a prospective way, the experience with video-assisted pericardioscopy obtained in patients with pericardial effusion of unclear etiology in the preoperative period. METHODS: From January 1998 to June 2000, 20 patients were operated upon with the aid of video-assisted pericardioscopy. On echocardiography, 17 of these patients had significant pericardial effusion, and 3 had moderate pericardial effusion. Video-assisted pericardioscopy was performed through a small incision of the Marfan type. RESULTS: The diagnosis of pericardial effusion was established as follows: idiopathic in 9 (45% patients, neoplastic in 4 (20%, resulting from hypothyroidism in 3 (15%, tuberculous in 2 (10%, due to cholesterol in 1 (5%, and chylopericardial in 1 (5%. The biopsy was positive in 30% of the patients, and the etiology could not be defined in 45% of the patients. CONCLUSION: Video-assisted pericardioscopy proved to be a method with low morbidity and a high index of diagnostic positivity. A high percentage of pericardial effusions are caused by viral infections, which are not diagnosed through current methods, being, therefore, classified as idiopathic.

  14. Etiology, diagnosis and management of severe pericardial effusion: A single center experience

    Directory of Open Access Journals (Sweden)

    Mehmet Aytürk

    2014-12-01

    Full Text Available Objective: To show etiology, diagnostic methods, and treatment options of patients with severe pericardial effusion determined after echocardiography. Methods: In this study, we retrospectively analyzed etiology, diagnosis and treatment options of 43 patients with severe pericardial effusions (i.e. effusions more than 20 mm either in front of the right ventricle or posterior to left ventricle as assessed by transthoracic echocardiography. The pericardiocentesis procedures were performed via subxiphoid approach. Glucose, protein, lactate dehydrogenase levels, polymerase chain reaction for tuberculosis, cytological, microbiological examinations and cultures were obtained from pericardial fluid. Results: Cardiac tamponade was diagnosed in 23 patients (54% and pericardiocentesis was immediately performed in these cases. Twenty patients who were unresponsive to empirical treatment, underwent pericardiocentesis to evaluate etiology and treatment.. Pericardial fluid was found to be exudate in 36 patients (83.7% and transudate in 7 patients (16.2%. The most common causes were malignancy (26%, and uremia (16% while idiopathic cases constituted 23% of the patient group. While malignant pericardial effusion was more common in males, idiopathic etiology and uremia were more common in female patients. Conclusion: Pericardiocentesis is the gold standard for clarifying the etiology and is also a lifesaving measure for cardiac tamponade. Delineating the specific etiology is particularly important for cases that do not respond to empirical treatment. A thorough history and physical examination, together with pericardiocentesis in selected cases will enable the accurate diagnosis of specific etiology and starting the treatment for this etiology.

  15. Instruments measuring blunted affect in schizophrenia: a systematic review.

    Directory of Open Access Journals (Sweden)

    Sanja Kilian

    Full Text Available Blunted affect, also referred to as emotional blunting, is a prominent symptom of schizophrenia. Patients with blunted affect have difficulty in expressing their emotions. The work of Abrams and Taylor and their development of the Rating Scale for Emotional Blunting in the late 1970's was an early indicator that blunted affect could indeed be assessed reliably. Since then, several new instruments assessing negative symptoms with subscales measuring blunted affect have been developed. In light of this, we aim to provide researchers and clinicians with a systematic review of the different instruments used to assess blunted affect by providing a comparison of the type, characteristics, administration and psychometric properties of these instruments. Studies reporting on the psychometric properties of instruments assessing blunted affect in patients with schizophrenia were included. Reviews and case studies were excluded. We reviewed 30 full-text articles and included 15 articles and 10 instruments in this systematic review. On average the instruments take 15-30 minutes to administer. We found that blunted affect items common across all instruments assess: gestures, facial expressions and vocal expressions. The CAINS Self-report Expression Subscale, had a low internal consistency score. This suggests that this sub-scale does not reliably assess patients' self-reported blunted affect symptoms and is likely due to the nature of blunted affect. Instruments correlated minimally with instruments measuring positive symptoms and more importantly with depression suggesting that the instruments distinguish between seemingly similar symptoms.

  16. Yellow Nail Syndrome Associated with Pericarditis and Pericardial Effusion: a Case Report

    Directory of Open Access Journals (Sweden)

    Vitorino Modesto dos Santos

    2015-10-01

    Full Text Available Yellow nail syndrome (YNS is an uncommon condition characterized by nail changes, lymphedema, in addition to pulmonary disorders and pleural effusion. Pericarditis and non-cardiac disorders can evolve with pericardial effusions including autoimmune conditions, hypothyroidism, malignancies, tuberculosis, and uremia. A 72-year-old Brazilian woman under treatment for arterial hypertension and hypothyroidism was admitted with pericarditis and pericardial effusion concomitant with yellow nail syndrome. She denied tobacco smoking, alcohol abuse, and similar disorders in her family. Clinical and complementary evaluation ruled out infectious diseases, malignancies, and autoimmune disorders as etiologic factors in this case. Hypothyroidism is a well-known cause of pericardial effusion, the vast majority in the absence of pericarditis, and has been described as an associated condition in some individuals with YNS. Case studies might contribute to better understanding of these causal or casual relationships.

  17. Management of cardiac perforation and pericardial tamponade complicating percutaneous balloon mitral valvuloplasty

    International Nuclear Information System (INIS)

    Objective: To determine the diagnostic and therapeutic approach of cute cardiac perforation and tamponade complicating percutaneous balloon mitral valvuloplasty. Methods and Results: Percutaneous balloon mitral valvuloplasty was performed in 772 patients with rheumatic mitral stenosis from May 1992 to Dec. 2001, 9 were diagnosed cardiac perforation, 2 which developed pericardial tamponade which was successfully controlled by contrast and X-ray guided pericardiocentesis using a sub-xiphoid approach. Conclusions: Only a minority of cardiac perforation resulted from PBMV developed pericardial tamponade. The latter could be controlled safely and effectively by contrast and X-ray guided pericardiocentesis using a sub-xiphoid approach. The diagnosis of pericardial tamponade during or after PBMV relies on a strong clinical suspicion, and contrast and X-ray guided pericardiocentesis should be carried out without echocardiography for patients in unstable state

  18. Adhesive intestinal obstruction following blunt abdominal trauma

    International Nuclear Information System (INIS)

    Advances in diagnosis and management of multiple trauma patients have lead to adopting a conservative approach for most patients with blunt abdominal trauma. Intestinal obstruction is a rare complication for this approach. Herein, we report a 37-year-old male, who did not have an abdominal operation, and who developed adhesive intestinal obstruction 7 weeks following blunt abdominal trauma. We detected no signs of peritonitis or intra-abdominal bleeding clinically or radiologically on admission. We initially treated the intestinal obstruction conservatively, but the obstruction did not resolve. Finally, we performed laparotomy, which showed that the small bowel was matted together by thick fibrous layers of adhesions. We performed adhesiolysis, and the patient was discharged home 3 weeks later. Histopathological findings of the fibrous layer were consistent with repair due to previous trauma and hemorrhage. We review the literature of this rare condition. (author)

  19. Ultrasound guided percutaneous drainage of pericardial fluid with an indwelling catheter

    Energy Technology Data Exchange (ETDEWEB)

    Ekberg, O.; Nilsson, P.E.; Aspelin, P.

    1986-10-01

    The technique of ultrasonographic guided percutaneous drainage of pericardial fluid, applied in three patients, is reported. The primary disease was synovial sarcoma, rheumatoid arthritis and prostatic carcinoma, respectively. Although three slightly different techniques and catheters were used all patients were sufficiently drained and the clinical symptoms promptly relieved. The catheters were left for drainage 3 months, 5 days and 14 days respectively. There were no major complications. One patient complained of transient palpitations. Percutaneous ultrasound-guided catheter drainage seems to be a safe method in patients with pericardial fluid where an indwelling catheter is considered.

  20. Spatial difference in pH in Lucilia cuprina (Diptera: Calliphoridae) pericardial cells

    Science.gov (United States)

    Lilje, Osu; Lilje, Erna S.

    2007-02-01

    Lucilia cuprina pericardial cells are primarily involved in the filtration of hemolymph. Ratio images using fluorescent pH indicator, DM-Nerf, were collected using a confocal microscope. The results support suggestions that there is zonation of cellular activity that reflect organelle distribution. Statistical analysis of the excitation ratios indicate significant spatial differences in pH of the three major zones- cortex, vacuole zone and endoplasm in pericardial cells. The outer cortex was estimated to have a pH between 5.5 and 6.8, the vacuole zone between 4.5 and 5.5 and the endoplasm between 4.0 and 5.0.

  1. Blunted Reward Responsiveness in Remitted Depression

    OpenAIRE

    Pechtel, Pia; Dutra, Sunny J; Elena L. Goetz; Pizzagalli, Diego A.

    2013-01-01

    Major Depressive Disorder has been associated with blunted responsiveness to rewards, but inconsistencies exist whether such abnormalities persist after complete remission. To address this issue, across two independent studies, 47 adults with remitted Major Depressive Disorder (rMDD) and 37 healthy controls completed a Probabilistic Reward Task, which used a differential reinforcement schedule of social or monetary feedback to examine reward responsiveness (i.e., ability to modulate behavior ...

  2. Screening US for blunt abdominal trauma: a retrospective study

    International Nuclear Information System (INIS)

    Purpose. To assess the accuracy of screening US in patients with blunt abdominal trauma first admitted in the trauma centre of our general hospital. Materials and methods. The reports of 864 abdominal US examinations of primary trauma patients (139 with major and 725 with minor injuries) obtained with standard protocols were retrieved. For each case, US reports were reviewed and compared to the test available reference standard. The accuracy of US was assessed by evaluating the method's overall ability to distinguish negative from positive cases by showing at least one of the lesions documented by the reference standard and its specific ability to depict injuries separately and independently. Results. US exhibited a satisfactory overall ability to distinguish negative from positive patients (91.5% sensibility and 97.5% specificity in major trauma patients vs. 73.3% sensibility and 98.1 % specificity in minor trauma patients) and a satisfactory specific ability to depict injuries separately and independently in major trauma patients. Of the 21/864 false negative reports (5 in patients with major and 16 in cases with minor trauma), only one affected patient management, a major trauma case, by delaying an emergency laparotomy. Conclusions. Its satisfactory accuracy for major trauma suggests that US could be employed not only to screen cases for emergency laparotomy but also as an alternative to screening CT. However, since major traumatic injuries generally carry an imperative indication for CT, especially as regards neurological, thoracic and skeletal evaluation, US has the not secondary task of performing a prompt preliminary examination using a simplified technique in the emergency room simultaneously with resuscitation

  3. A PROSPECTIVE STUDY OF TRAUMATIC CATARACT AND ITS VISUAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Siddharam S

    2014-06-01

    Full Text Available : INTRODUCTION: Ocular trauma is the leading cause of unilateral blindness all over the world.[1] The incidence of ocular trauma varies in different parts of the world. From India, the reported incidence is 20.53%.[2] Any strategy for prevention requires knowledge of the cause of injury, which may enable more appropriate targeting of resources towards preventing such injuries.[3] Eye trauma represents a large, potentially preventable burden on both victims and society as a whole. Traumatic cataracts occur secondary to blunt or penetrating ocular trauma, Infrared energy (glass-blower's cataract, electric shock and ionizing radiation are other rare causes of traumatic cataracts.[4] It form a separate category of cataracts as they present with other ocular morbidity like corneal tears, iris injury, vitreous hemorrhage and retinal tears; and they are to some extent, preventable. The methods used to evaluate the visual outcome in eyes managed for traumatic cataracts and senile cataracts are similar, but the damage to other ocular tissues owing to trauma may compromise the visual gain in eyes treated surgically for traumatic cataracts.[5] Hence, the success rates may differ between eyes with these two types of cataract. The aim of this study was to evaluate the final visual outcome of a patient with surgical extraction of traumatic cataract along with demographic features and modes of trauma.

  4. Epidemiology of pericardial effusions at a large academic hospital in South Africa.

    Science.gov (United States)

    Reuter, H; Burgess, L J; Doubell, A F

    2005-06-01

    The aim was to establish the prevalence of large pericardial effusions in the Western Cape Province of South Africa, and to determine the incidence of various types of effusions. A total of 233 patients presented with large pericardial effusions. Each patient underwent tests for HIV, sputum smear and culture, blood culture, blood biochemistry and serological testing. Tuberculous pericardial effusions were diagnosed according to pre-determined criteria. Eighty-four patients (36.1%) were found to be HIV positive; 81 of these (96.4 %) had tuberculous pericarditis. More than 65% of the study population was aged between 15 and 39 years. The prevalence of HIV amongst unemployed individuals was 49.0% compared to 30.0% amongst employed individuals. Tuberculous pericarditis was the most common cause of pericardial effusions (69.5%, n=162). It was concluded that tuberculosis (TB) is a leading cause of pericarditis in this province of South Africa. The prevalence of TB confounded by HIV co-infection is steadily increasing, burdening the health-care facilities. PMID:15962545

  5. Bilious pericardial effusion at initial presentation in a patient with lung cancer

    Directory of Open Access Journals (Sweden)

    Kostikas Konstantinos

    2003-11-01

    Full Text Available Abstract Background Cardiac tamponade as the initial manifestation of metastatic cancer is a rare clinical entity. Furthermore, a thoraco-biliary fistula is another rare complication of echinococcosis due to rupture of hydatid cysts located at the upper surface of the liver to the pleural or pericardial cavity. We report a case of non-small cell lung cancer with a coexisting hepatic hydatid cyst presenting as a bilious pericardial effusion. Case report A 66-year-old patient presented with cardiac tamponade of unknown origin. Chest CT-scan demonstrated a left central lung tumor, a smaller peripheral one, bilateral pleural effusions and a hydatid cyst on the dome of the liver in close contact to the diaphragm and pericardium. Pericardiotomy with drainage was performed, followed by bleomycin pleurodesis. The possible mechanism for the bilious pericardial effusion might be the presence of a pericardio-biliary fistula created by the hepatic hydatid cyst. Conclusions This is the first case of a bilious pericardial effusion at initial presentation in a patient with lung cancer with coexisting hepatic hydatid cyst.

  6. Pericardial and abdominal fluid accumulation in congenital disorder of glycosylation type Ia.

    NARCIS (Netherlands)

    Truin, G.; Guillard, M.; Lefeber, D.J.; Sykut-Cegielska, J.; Adamowicz, M.; Hoppenreijs, E.; Sengers, R.C.A.; Wevers, R.A.; Morava, E.

    2008-01-01

    The association of fetal hydrops with Congenital Disorders of Glycosylation (CDG) has been reported previously. Pericardial fluid accumulation and ascites were also observed in a few young patients with CDG type Ia. Here we describe the clinical and biochemical features in three children developing

  7. ABDOMINAL PERICARDIAL SINUS: A NEUROHEMAL SITE IN THE TSETSE AND OTHER CYCLORRAPHAN FLIES

    Science.gov (United States)

    An ultrastructural study of the heart of the tsetse fly, Glossina morsitans, and of several other species of cyclorraphan flies revealed that the ventral region of the heart of adult flies is encircled by a muscular septum not present in the larval stage. The pericardial septum of the adult heart ...

  8. Pericardial effusion in atrial fibrillation ablation: a comparison between cryoballoon and radiofrequency pulmonary vein isolation.

    NARCIS (Netherlands)

    Chierchia, G.B.; Capulzini, L.; Droogmans, S.; Sorgente, A.; Sarkozy, A.; Muller-Burri, A.; Paparella, G.; Asmundis, C. de; Yazaki, Y.; Kerkhove, D.; Camp, G. van; Brugada, P.

    2010-01-01

    AIMS: Atrial fibrillation (AF) ablation is increasingly being performed in electrophysiology laboratories. Pericardial effusion (PE) is certainly one of the most frequently observed complications during AF ablation. The aim of our study was to investigate the incidence and outcome of PE following cr

  9. Isolated duodenal rupture due to blunt abdominal trauma

    Directory of Open Access Journals (Sweden)

    Celik Atilla

    2006-01-01

    Full Text Available Duodenal rupture following blunt abdominal trauma is rare and it usually seen with other abdominal organ injuries. It represents approximately 2% to 20% of patients with blunt abdominal injury and often occurs after blows to the upper abdomen, or abdominal compression from high-riding seat belts. Two cases of blunt duodenal rupture successfully treated surgically, are presented with their preoperative diagnosis and final out comes.

  10. Post-traumatic hepatic pseudoaneurysms in children

    International Nuclear Information System (INIS)

    Background. Post-traumatic hepatic artery pseudoaneurysms are rarely seen in children. Materials and methods. We retrospectively reviewed the radiologic studies and medical records of three patients treated at our institution and reviewed the literature. The patients (ages 5-13 years) presented immediately to 2 months after blunt (two patients) and penetrating (one patient) trauma. The hepatic pseudoaneurysms were discovered during work-up for fever (one patient), gastrointestinal bleeding and hyperbilirubinemia (one patient), or widened mediastinum (one patient) on chest radiograph. In two patients, the diagnosis was initially suspected by computed tomography (CT) examination and confirmed by angiography. In the third patient, the diagnosis was made initially by angiography. All three pseudoaneurysms were treated with transcatheter embolization. Results. All three embolizations were initially technically successful. However, there was recurrence in one case, in which embolization distal to the neck of the pseudoaneurysms was not technically possible. With conservative management, however, the residual lesion demonstrated spontaneous occlusion by ultrasound (US) at 6 months. Conclusion. This uncommon complication of liver trauma in children can have a delayed presentation, can be clinically unsuspected, and can follow blunt or penetrating trauma. Endovascular embolotherapy is the treatment of choice. (orig.)

  11. Post-traumatic hepatic pseudoaneurysms in children

    Energy Technology Data Exchange (ETDEWEB)

    Sidhu, M.K. [Department of Diagnostic Imaging, Children`s Hospital Oakland, CA (United States); Shaw, D.W.W. [Department of Radiology, Children`s Hospital and Medical Center, Seattle, Washington (United States); Daly, C.P. [Department of Radiology, University of Washington Hospital and Medical Center, Seattle, Washington (United States); Waldhausen, J.H. [Department of Surgery, Children`s Hospital and Medical Center, Seattle, Washington (United States); Coldwell, D. [Department of Radiology, Denver General Hospital, Denver, Colorado (United States)

    1999-01-01

    Background. Post-traumatic hepatic artery pseudoaneurysms are rarely seen in children. Materials and methods. We retrospectively reviewed the radiologic studies and medical records of three patients treated at our institution and reviewed the literature. The patients (ages 5-13 years) presented immediately to 2 months after blunt (two patients) and penetrating (one patient) trauma. The hepatic pseudoaneurysms were discovered during work-up for fever (one patient), gastrointestinal bleeding and hyperbilirubinemia (one patient), or widened mediastinum (one patient) on chest radiograph. In two patients, the diagnosis was initially suspected by computed tomography (CT) examination and confirmed by angiography. In the third patient, the diagnosis was made initially by angiography. All three pseudoaneurysms were treated with transcatheter embolization. Results. All three embolizations were initially technically successful. However, there was recurrence in one case, in which embolization distal to the neck of the pseudoaneurysms was not technically possible. With conservative management, however, the residual lesion demonstrated spontaneous occlusion by ultrasound (US) at 6 months. Conclusion. This uncommon complication of liver trauma in children can have a delayed presentation, can be clinically unsuspected, and can follow blunt or penetrating trauma. Endovascular embolotherapy is the treatment of choice. (orig.) With 3 figs., 22 refs.

  12. Kuula. Kellele ei meeldiks James Blunt? / Mart Juur

    Index Scriptorium Estoniae

    Juur, Mart, 1964-

    2007-01-01

    Heliplaatidest: James Blunt "Back To Bedlam", Enrique Iglesias "Insomniac", Prince "Planet Earth", Garbage "Absolut Garbage", Justice "Cross", Interpol "Our Love To Admire", Rufus Wainwright "Release The Stars"

  13. CT of blunt hepatic trauma in children

    International Nuclear Information System (INIS)

    CT findings of blunt hepatic trauma were studied in 27 children. Liver injury was classified into 3 types from mild to severe. Liver contusion was observed in 1, liver laceration in 21, and liver rupture in 5. Only 2 patients (7.4%) required surgery, and the others could be managed by conservative therapy. CT, which accurately reveals not only the severity of liver injury but also injuries of other abdominal organs and intraperitoneal bleeding, is important for the diagnosis of liver injury and determination of its treatment. (author)

  14. Fatigue crack growth from blunt notches

    International Nuclear Information System (INIS)

    A number of methods have been proposed, by which the formation and early growth of fatigue cracks at blunt notches may be predicted. In this report, four methods are compared - i.e. analysis of the crack tip plastic deformation, the cyclic contour integral, δJ, the strain in a critical volume of material, and the notch root plastic strain range. It is shown that these approaches have fundamental elements in common, and that all are compatable with linear elastic fracture mechanics. Early results from a continuing experimental programme are reported. (orig.)

  15. Bullhorn hernia: A rare traumatic abdominal wall hernia

    OpenAIRE

    Bimaljot Singh; Ashwani Kumar; Adarshpal Kaur; Rachan Lal Singla

    2015-01-01

    Traumatic abdominal wall hernia (TAWH) is rare despite the high prevalence of blunt abdominal trauma. Bullhorn hernia occurs as a result of a direct blow to the abdominal wall by the horn of a bull, which disrupts the muscles and fascia and leads to hernia formation. We report a rare case of bullhorn TAWH in a 70-year-old patient who presented with swelling at the left lumbar region. The patient was managed by immediate surgical intervention. A surgeon must have high index of suspicion for th...

  16. Bullhorn hernia: A rare traumatic abdominal wall hernia

    Directory of Open Access Journals (Sweden)

    Bimaljot Singh

    2015-01-01

    Full Text Available Traumatic abdominal wall hernia (TAWH is rare despite the high prevalence of blunt abdominal trauma. Bullhorn hernia occurs as a result of a direct blow to the abdominal wall by the horn of a bull, which disrupts the muscles and fascia and leads to hernia formation. We report a rare case of bullhorn TAWH in a 70-year-old patient who presented with swelling at the left lumbar region. The patient was managed by immediate surgical intervention. A surgeon must have high index of suspicion for the diagnosis of this condition as missed hernias in this setting pose a high risk of strangulation and gangrene.

  17. The usefulness of computed tomography in evaluating patients with blunt abdominal trauma

    International Nuclear Information System (INIS)

    During the past 28 months since the opening of our critical care medical center, a total of 31 patients with blunt abdominal trauma underwent CT scanning. CT findings were analyzed and compared for intraoperative findings and clinical courses. Parenchymal organ trauma is easily able to be diagnosed by CT scan, which provides definite information about the site, shape and bleeding condition of the traumatic lesion. A high-density hematoma in the mesenterium indicating the site of trauma, following bowel ischemia should be carefully observed. For assessment of bowel trauma with any modality, careful observation is also needed, because there are almost no findings in the early stage. Contrast CT was valuable in that we could obtain definite information on the site of bleeding, roughly know the vascular injury, and examine the urinary tract by additional plain film. (author)

  18. Traumatic Aneurysm of Innominate Artery Resulting in Tracheal Stenosis and Rapidly Progressive Respiratory Failure; A Case Report and Literature Review

    Science.gov (United States)

    Hodjati, Hossein; Mardani, Parviz; Mousavi, Masoud; Hoseinzadeh, Ahmad; Ahmadi, Sajjad; Sohrabi, Sahar; Golchini, Alireza

    2015-01-01

    Traumatic injuries to great vessels are relative common in trauma practice. Blunt thoracic trauma may result in dissection injury to aorta and innominate artery. We herein present a late presentation of traumatic innominate artery aneurysm. A29-year-old woman presented with dyspnea to our emergency department. She had previous motor-vehicle accident a month before presentation for which had undergone chest tube insertion. She was diagnosed to have traumatic aneurysm of innominate artery resulting in tracheal stenosis resulting in acute life threatening respiratory failure. She underwent simultaneous aneurysm resection and tracheal reconstruction. She was uneventfully discharged from hospital. Any post-traumatic respiratory and cardiovascular symptoms may propound an undiagnosed serious injury to the great vessels. Extra and repetitive imaging studies may help us in better evaluation of traumatized patients with high energy mechanisms and sharp injuries to chest and neck. PMID:27162913

  19. VSD following blunt cardiac trauma: MRI findings.

    Science.gov (United States)

    Liguori, Andrew E; Maertins, Benjamin A; Richardson, Randy

    2013-10-01

    In this report, we describe the clinical and radiographic findings of ventricular septal defects (VSDs) following blunt cardiac trauma in two patients. VSDs following either penetrating or blunt cardiac trauma are a rare occurrence. The variable presentation and timing of symptom onset along with the common association of other injuries can make the diagnosis of a posttraumatic VSD difficult. Therefore, investigation should be initiated when elements from the history and physical examination (e.g., new onset murmur), laboratory tests (e.g., cardiac enzymes), EKG, and CT or echocardiography warrant it. The first patient was a 19-year-old male who was hemodynamically stable on initial presentation to this trauma center after a motor vehicle collision. A posttraumatic VSD was found by echocardiography on the day of admission and further defined on cardiac MRI (CMRI). The second patient was a 31-year-oid male who presented after a high-speed motorcycle accident and was found to have a VSD 40 days later on CMRI after a fluctuating clinical course and multiple normal echocardiograms. Both patients had good outcomes with subsequent surgical closure. PMID:23604922

  20. CT of blunt chest trauma in children

    International Nuclear Information System (INIS)

    While trauma is still the leading cause of death in the pediatric age range, it is surprising how little the CT appearances of pediatric chest injury have been investigated in the literature. We have reviewed the CT findings of blunt chest trauma in 44 children for whom chest CT examinations were requested to investigate the extent of intrathoracic injury. We noted a propensity for pulmonary contusions to be located posteriorly or posteromedially, and for them to be anatomically nonsegmental and crescentic in shape. This is possibly attributable to the relatively compliant anterior chest wall in children. The CT appearances of other major thoracic injuries are described, including pulmonary lacerations, pneumothoraces, malpositioned chest tubes, mediastinal hematomas, aortic injury, tracheobronchial injury, hemopericardium, and spinal injuries with paraspinal fluid collections. Children demonstrating findings incidental to the actual injury yet important to the subsequent therapy are also presented. We conclude that, in the event of clinically significant blunt chest trauma, the single supine chest examination in the trauma room is insufficient to adequately identify the extent of intrathoracic injury. With the exception of concern for aortic injury for which aortography is indicated, a dynamically enhanced CT scan of the thorax should be performed as clinically significant findings may result in altered therapy. (orig.)

  1. Multidetector CT of blunt abdominal trauma.

    Science.gov (United States)

    Soto, Jorge A; Anderson, Stephan W

    2012-12-01

    The morbidity, mortality, and economic costs resulting from trauma in general, and blunt abdominal trauma in particular, are substantial. The "panscan" (computed tomographic [CT] examination of the head, neck, chest, abdomen, and pelvis) has become an essential element in the early evaluation and decision-making algorithm for hemodynamically stable patients who sustained abdominal trauma. CT has virtually replaced diagnostic peritoneal lavage for the detection of important injuries. Over the past decade, substantial hardware and software developments in CT technology, especially the introduction and refinement of multidetector scanners, have expanded the versatility of CT for examination of the polytrauma patient in multiple facets: higher spatial resolution, faster image acquisition and reconstruction, and improved patient safety (optimization of radiation delivery methods). In this article, the authors review the elements of multidetector CT technique that are currently relevant for evaluating blunt abdominal trauma and describe the most important CT signs of trauma in the various organs. Because conservative nonsurgical therapy is preferred for all but the most severe injuries affecting the solid viscera, the authors emphasize the CT findings that are indications for direct therapeutic intervention. PMID:23175542

  2. An unusual complication of blunt ocular trauma: A horseshoe-shaped macular tear with spontaneous closure

    Directory of Open Access Journals (Sweden)

    Umut Karaca

    2014-01-01

    Full Text Available A case of horseshoe-shaped macular tear after blunt trauma with the course of the tear and the relevant findings obtained by spectral-domain optical coherence tomography (SD-OCT is described. A 21-year-old man who had suffered blunt trauma 5 days previously visited our clinic complaining of vision loss in his left eye. Ophthalmic examination and SD-OCT images revealed a horseshoe-shaped macular tear. A month later at the second visit, the macular tear was found to have spontaneously closed. There have been many cases reported previously of the spontaneous closure of traumatic macular holes. A horseshoe-shaped macular tear is an atypical clinical presentation. However, the mechanism of spontaneous closure is hypothetically as same as that for a macular hole. High-resolution images and three-dimensional maps taken with SD-OCT can provide more details on macular diseases and are more useful than time-domain OCT images.

  3. Malignant pleural and pericardial effusions and meningeal infiltrates without other metastases in breast cancer: A case report

    Science.gov (United States)

    LV, XINGXING; HE, JINLAN; SHEN, YUAN; ZHENG, HONG

    2016-01-01

    Breast cancer metastasizing to the pleura, pericardium and leptomeninges, but not to other sites, is rare. Although malignant pericardial and pleural effusions are common complications during the course of malignancies, they are rarely the initial manifestations of malignant disease, particularly pericardial effusion with cardiac tamponade. This report describes a case of breast carcinoma in a 44-year-old woman who initially presented with malignant pleural effusion and pericardial tamponade and suffered from meningeal metastases after 4.5 months. Unfortunately, the patient succumbed to pericardial tamponade 7 months later. There was no metastasis identified in other organs during the course of the disease. To the best of our knowledge, no similar case has been reported in the literature to date. PMID:27123295

  4. Unrecognized blunt tracheal trauma with massive pneumomediastinum and tension pneumothorax

    OpenAIRE

    Nanda Shetty; H M Krishna; Elsa Varghese; Subhashree, J; Arushi Gupta

    2011-01-01

    Blunt neck trauma with an associated laryngotracheal injury is rare. We report a patient with blunt neck trauma who came to the emergency room and was sent to ward without realizing the seriousness of the situation. He presented later with respiratory distress and an anesthesiologist was called in for emergency airway management. Airway management in such a situation is described in this report.

  5. Aortic bifurcation tear following blunt trauma in childhood

    OpenAIRE

    Shlomo Yellinek; Dimitri Gimelrich; Ofer Merin; Petachia Reissman; Marc Arkovitz

    2015-01-01

    Rupture of the abdominal aorta from blunt trauma is rare and aortic biforcation tear is extremely rare. We will present the management of a 2 year old boy who suffered blunt abdominal trauma and was operated in urgent fashion in our institution.

  6. Post-traumatic tricuspid valve insufficiency. 2 cases of delayed clinical manifestation.

    OpenAIRE

    Bortolotti, U; Scioti, G; Milano, A; Guglielmi, C; Benedetti, M; Tartarini, G; Balbarini, A

    1997-01-01

    We present 2 cases of tricuspid insufficiency following blunt chest trauma: 1 was diagnosed 5 months after the trauma and the other, 20 years after the trauma. In both patients, the tricuspid valve was replaced with a porcine bioprosthesis, because valve repair was not considered feasible. These cases emphasize the variability of clinical presentation of post-traumatic tricuspid valve insufficiency and indicate the need for close follow-up of patients after major thoracic trauma.

  7. A rare case of chronic traumatic diaphragmatic hernia requiring complex abdominal wall reconstruction

    OpenAIRE

    Andrea Pakula; Amber Jones; Javed Syed; Ruby Skinner

    2015-01-01

    Introduction: Traumatic diaphragmatic hernia is a rare and often under recognized complication of penetrating and blunt trauma. These injuries are often missed or there is a delay in diagnosis which can lead to enlargement of the defect and the development of abdominal or respiratory symptoms. Presentation of case: We report a case of an otherwise healthy 37 year old male who was involved in a motor vehicle accident at age twelve. He presented 25 years later with vague lower abdominal symp...

  8. Are traumatic bilateral adrenal injuries associated with higher morbidity and mortality?-A prospective observational study

    OpenAIRE

    Panda, Ananya; Kumar, Atin; Gamanagatti, Shivanand; Bhalla, Ashu Seith; Sharma, Raju; Kumar, Subodh; Mishra, Biplab

    2015-01-01

    Background Traumatic bilateral adrenal injuries are uncommon. Adrenal injuries are overall associated with worse outcome than non-adrenal injuries. However, direct comparative evidence between unilateral and bilateral adrenal injuries is unavailable in literature. This study aims to investigate clinical significance of bilateral adrenal hematomas in terms of injury severity, morbidity and mortality. Methods All blunt trauma abdomen patients with adrenal gland involvement on initial CECT scans...

  9. Traumatic diaphragmatic rupture, a diagnostic dilemma in the presence of eventration: a case report

    OpenAIRE

    Lone, Reyaz Ahmad; Sharma, Mukand Lal; Wani, Mahmood; Rather, Shiraz; Ahangar, Abdul Gani; Rasool, Fouzia; Bhat, Mohd Akbar; Dar, Abdul Majid; Lone, Guhlam Nabi; Singh, Shyam; Mir, Ishtiyaq; Shah, Shabir; Shah, Mubashir; Wani, Mohd Lateef

    2009-01-01

    Eventration of the diaphragm is the condition where the muscle is permanently elevated, but retains its continuity and attachments to the costal margins. Traumatic diaphragmatic rupture is a recognized consequence of high velocity blunt trauma to the abdomen usually a result of motor vehicle accident. Multi-slice CT and Magnetic Resonance Imaging in the pre-operative evaluation of trauma patients, diaphragmatic rupture can be still overlooked if not evaluated with the fair degree of clinical ...

  10. Links between traumatic brain injury and ballistic pressure waves originating in the thoracic cavity and extremities

    OpenAIRE

    Courtney, Amy; Courtney, Michael

    2008-01-01

    Identifying patients at risk of traumatic brain injury (TBI) is important because research suggests prophylactic treatments to reduce risk of long-term sequelae. Blast pressure waves can cause TBI without penetrating wounds or blunt force trauma. Similarly, bullet impacts distant from the brain can produce pressure waves sufficient to cause mild to moderate TBI. The fluid percussion model of TBI shows that pressure impulses of 15-30 psi cause mild to moderate TBI in laboratory animals. In pig...

  11. Arch vessel injury: geometrical considerations. Implications for the mechanism of traumatic myocardial infarction II

    OpenAIRE

    Ismailov Rovshan M

    2006-01-01

    Abstract Background Various types of vascular injury have been reported in the medical literature; the isthmic part of the aorta is at particularly high risk of traumatic rupture. Early diagnosis results in better survival, justifying the search for potential risk factors and diagnostic tests. The aim of this research was to investigate the complex mechanism of blunt injury to the vascular wall with particular focus on the branching region of the vessels. Geometric peculiarities were investig...

  12. Mild traumatic brain injury.

    NARCIS (Netherlands)

    Vos, P.E.; Alekseenko, Y.; Battistin, L.; Ehler, E.; Gerstenbrand, F.; Muresanu, D.F.; Potapov, A.; Stepan, C.A.; Traubner, P.; Vecsei, L.; Wild, K. von

    2012-01-01

    Traumatic Brain Injury (TBI) is among the most frequent neurological disorders. Of all TBIs 90% are considered mild with an annual incidence of 100-300/100.000. Intracranial complications of Mild Traumatic Brain Injury (MTBI) are infrequent (10%), requiring neurosurgical intervention in a minority o

  13. Pericardial tamponade and pancytopenia as the first manifestation of mixed connective tissue disorder and its complete reversal with corticosteroids

    OpenAIRE

    Ankur Jain

    2014-01-01

    We report a case of a 25-year-old lady who presented to our department with complaints of easy fatigability and shortness of breath since one week. She had a history of Raynaud’s phenomenon. Examination revealed scleroderma like skin changes and pericardial friction rub. Investigations revealed high titer of anti-U1 RNP antibodies along with co-existing pancytopenia. Chest x-ray and echocardiography confirmed pericardial tamponade. Patient was diagnosed as having mixed connective tissue disor...

  14. Myogenic differentiation and reparative activity of stromal cells derived from pericardial adipose in comparison to subcutaneous origin

    OpenAIRE

    Wang, Xiaoming; Zhang, Hui; Nie, Liangming; Xu, Linhai; Chen, Min; Ding, Zhaoping

    2014-01-01

    Introduction Adipose tissue-derived stromal cells (ADSCs) are abundant and easy to obtain, but the diversity of differentiation potential from different locations may vary with the developmental origin of their mesenchymal compartment. We therefore aim to compare the myogenic differentiation and reparative activity of ADSCs derived from the pericardial tissue to ADSCs of subcutaneous origin. Methods Pericardial and inguinal adipose tissues from Wistar rats were surgically obtained, and the st...

  15. The value of serum tumour markers in the prediction of aetiology and follow up of patients with pericardial effusion

    OpenAIRE

    Bildirici, U; Celikyurt, U; ACAR, E.; Sahin, T.; Kozdag, G; Ural, D; Bulut, O

    2012-01-01

    Background The aim of this study was to evaluate the value of tumour markers in the differential diagnosis of pericardial effusions and to assess their changing levels during follow up. Methods Sixty-nine patients who were admitted to hospital with a diagnosis of pericardial effusion were included in the study. Serum tumour markers were measured on admission and after a mean of 18 ± 7 months’ follow up. An aetiological diagnosis was made on clinical evaluation, imaging techniques and biochemi...

  16. Right hepatic vein injury after blunt abdominal trauma in a 12-year-old boy- case report

    International Nuclear Information System (INIS)

    Blunt abdominal trauma in children is one of the most frequent causes of hospitalization. We present a rare case of traumatic liver injury. A 12-year-old boy was admitted to the Surgery Department after a bicycle fall and handlebar impact injury to the right infracostal area. At admission he was stable, with no abnormalities except for a subcutaneous hepatoma found in the injured area. Abdominal ultrasound examination revealed free intraperitoneal fluid. Computed tomography (CT) revealed irregular branching laceration of the right superior hepatic segments with extension into the hepatic veins. No active extravasation of contrast material was seen. On the next day, cause of the deterioration of the patient's condition, CT examination was repeated and revealed focal extravasation of contrast material in the portal hilum posterior to the gallbladder. An injury of the right hepatic vein was found on laparotomy. Hepatic vein injury is a rare but very serious complication after blunt liver trauma and it is an indication for surgical treatment. Diagnostic imaging is essential for therapeutic decisions, but its value is sometimes limited.The precise analysis of injury mechanism and localization may be very helpful.CT is currently the modality of choice for the evaluation of blunt liver trauma. If an active bleeding is suspected the delayed scans seem to be recommended. (author)

  17. Staging and treatment of blunt renal trauma

    International Nuclear Information System (INIS)

    Based on adequate radiological and other clinical data available in our 21 consecutive patients with blunt renal traumas (16 lacerations and 5 contusions), we studied whether the treatments adopted had been judicious and whether radiological and other clinical findings could be characterized for each group with different treatment modalities. In cases with stable vital signs, renal lacerations were associated with relatively small hematomas and these cases were treated safely by bed rest for about 1 month. Cases with unstable vital signs had large voluminous hematomas and renal lacerations often associated with significant diastasis. In these patients with major renal injuries who required surgical intervention, angiography was useful for evaluating the lesions and arterial embolization was very useful for stabilizing the patients' conditions and fascilitating the subsequent surgical treatments. (author)

  18. Hemoglobin-associated Oxidative Stress in the Pericardial Compartment of Post-operative Cardiac Surgery Patients

    OpenAIRE

    Kramer, Philip A.; Chacko, Balu K; Ravi, Saranya; Johnson, Michelle S.; Mitchell, Tanecia; Barnes, Stephen; Arabshahi, Alireza; Dell’Italia, Louis J.; George, David J.; Steele, Chad; George, James F.; Darley-Usmar, Victor M.; Melby, Spencer J.

    2014-01-01

    Atherosclerosis and valvular heart disease often require treatment with corrective surgery to prevent future myocardial infarction, ischemic heart disease, and heart failure. Mechanisms underlying the development of the associated complications of surgery are multifactorial and have been linked to inflammation and oxidative stress, classically as measured in the blood or plasma of patients. Post-operative pericardial fluid (PO-PCF) has not been investigated in depth with respect to the potent...

  19. Fibrinous Pericardial Effusion and Valvulitis Secondary to Previous Acute Rheumatic Fever: An Unusual Clinical Presentation

    OpenAIRE

    Osman Yılmaz; Ömer Kılıç; Murat Çiftel

    2014-01-01

    Rheumatic heart disease, a sequela to acute rheumatic fever (ARF), is a major cause of acquired heart disease in children and young adults in developing countries. Valvular disease of variable severity, heart failure, and pericarditis has been observed in patients with rheumatic heart disease. A 12-year-old female patient presented with fever presented for 3 days, continuing for fatigue, exhaustion, and chest pain. Echocardiography revealed a pericardial effusion with a 24-mm-thick fibrin acc...

  20. Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine.

    Science.gov (United States)

    Iles, Tinen L; Howard, Brian; Howard, Stephen; Quallich, Stephen; Rolfes, Christopher; Richardson, Eric; Iaizzo, Hanna R; Iaizzo, Paul A

    2016-01-01

    To date, many pharmacological agents used to treat or prevent arrhythmias in open-heart cases create undesired systemic side effects. For example, antiarrhythmic drugs administered intravenously can produce drops in systemic pressure in the already compromised cardiac patient. While performing open-heart procedures, surgeons will often either create a small port or form a pericardial cradle to create suitable fields for operation. This access yields opportunities for target pharmacological delivery (antiarrhythmic or ischemic preconditioning agents) directly to the myocardial tissue without undesired side effects. We have developed a swine model for testing pharmacological agents for target delivery within the pericardial fluid. While fully anesthetized, each animal was instrumented with a Swan-Ganz catheter as well as left and right ventricle pressure catheters, and pacing leads were placed in the right atrial appendage and the right ventricle. A medial sternotomy was then performed and a pericardial access cradle was created; a plunge pacing lead was placed in the left atrial appendage and a bipolar pacing lead was placed in the left ventricle. Utilizing a programmer and a cardiac mapping system, the refractory period of the atrioventricular node (AVN), atria and ventricles was determined. In addition, atrial fibrillation (AF) induction was produced utilizing a Grass stimulator and time in AF was observed. These measurements were performed prior to treatment, as well as 30 min and 60 min after pericardial treatment. Additional time points were added for selected studies. The heart was then cardiopleged and reanimated in a four chamber working mode. Pressure measurements and function were recorded for 1 hr after reanimation. This treatment strategy model allowed us to observe the effects of pharmacological agents that may decrease the incidence of cardiac arrhythmias and/or ischemic damage, during and after open-heart surgery. PMID:27500319

  1. Atherosclerosis associated with pericardial effusion in a central bearded dragon (Pogona vitticeps).

    Science.gov (United States)

    Schilliger, Lionel; Lemberger, Karin; Chai, Norin; Bourgeois, Aude; Charpentier, Maud

    2010-09-01

    Atherosclerosis is a common disease in pet birds, particularly in psittacines, and is frequently found when performing postmortem examinations on adult and old dogs, in which it is mainly associated with endocrine diseases, such as hypothyroidism and diabetes mellitus. However, atherosclerosis is poorly documented in reptiles and consequently poorly understood. In the current case report, atherosclerosis and pericardial effusion were diagnosed in a 2-year-old male central bearded dragon (Pogona vitticeps) based on ultrasound visualization, necropsy, and histologic examination. PMID:20807945

  2. Commentary on: Pericardial Fat is Independently Associated with Human Atrial Fibrillation by Al Chekakie et al.

    OpenAIRE

    Omar Batal, MD; Mina K. Chung, MD

    2010-01-01

    Obesity is an established risk factor for atrial fibrillation (AF).1 In fact, it has been reported that the increasing prevalence of obesity in the United States could account for up to 60 % of the increasing incidence of age and sex adjusted AF.2 Adipose tissue has been shown to be highly metabolically active and secretes several proinflammatory mediators; however, different fat depots differ in metabolic and inflammatory activity.3 Pericardial fat produces several inflammatory cytokines and...

  3. Blunt Abdominal Wall Disruption by Seatbelt Injury; A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Maarten Philip Cornelissen

    2016-04-01

    Full Text Available With the introduction of the use of seatbelts in cars, mortality following motor vehicle crashes has decreased significantly. However, two patterns of injuries, the ‘seatbelt sign’ and ‘seatbelt syndrome’ have emerged. Injuries may consist of traumatic abdominal wall disruption. We present two cases of severe abdominal wall disruption caused by a seatbelt injury and treated with primary repair. A review of the literature is provided. Two patients were brought in after a high velocity Motor Vehicle Collision. Both presented with an acute abdomen and a seatbelt sign upon which the decision was made to perform emergency laparotomies. Both patients had an abdominal wall disruption along the seatbelt sign. These disruptions were primarily closed and during six months of follow-up no complications occurred. A disruption of the abdominal wall is a rare complication. However, it is a diagnosis that may not be missed as patients have a higher risk of morbidity and mortality. CT-scanning is an accurate method to detect disruptions. Closure of blunt traumatic abdominal wall disruption can be done primarily with sutures or addition of a mesh. In both cases of the severe abdominal wall disruption, primary repair without mesh in the acute phase was successful. When a laparotomy is not indicated, the abdominal wall must be assessed for disruption. If there is a disruption primary repair is a good option.

  4. ACUTE PHASE REACTANCTS IN PERICARDIAL FLUID ARE INDICATORS OF CORONARY ARTERY DISEASE

    Directory of Open Access Journals (Sweden)

    Yılmaz Mehmet Ali

    2012-12-01

    Full Text Available Inflammation in formation of atherosclerosis, and acute phase reactants in the site of inflammation have major functions. Thus, do the acute phase reactants constitute the biggest risk factor for coronary artery disease? 55 patients are included in the study. Patients with coronary artery bypass surgery are included in Group I (38 patients and patients with valve operation are included in Group II (17 patients. CABG patients are further divided into two sub-groups as on-pump and off-pump. In both groups, homocystein, high sensitivity C reactive protein, ceruloplasmin, lipoprotein A and serum amyloid A protein levels are analyzed from blood and pericardial fluid. In patients with coronary artery disease, the measured high specific C- reactive protein levels from blood and pericardial fluid are found to be significantly high compared to patients with valve operation.Homocystein levels of pericardial fluids of patients with CABG are found to be higher than patients with valve operation and it is confirmed that the situation is correlated with blood homocystein levels. Although there are lots studies expressing the relation between coronary artery disease and lipoprotein A, ceruloplasmin and serum amyloid A protein levels; no significant difference for those parameters was obtained in our study. We determined that other phase reactants are higher in patients with coronary artery disease, in accordance with the literature. We aimed to state that acute phase reactants not only increase as a result of disease, but their levels are also elevated beforehand, as an indicator of the disease.

  5. Fungal myocarditis and pericardial effusion secondary to Inonotus tropicalis (phylum Basidiomycota) in a dog.

    Science.gov (United States)

    Ribas, Thibault; Pipe-Martin, Hannah; Kim, Kenneth S; Leissinger, Mary K; Bauer, Rudy W; Grasperge, Britton J; Grooters, Amy M; Sutton, Deanna A; Pariaut, Romain

    2015-06-01

    Fungal disease is a rare cause of pericardial effusion in dogs. This report describes the first case of fungal pericardial effusion and myocarditis secondary to the fungal organism Inonotus tropicalis. A 9-year-old female spayed French bulldog with a multi-year history of treatment with glucocorticoids for management of atopy was presented for exercise intolerance, ascites and weight loss. Physical examination and thoracic imaging revealed enlarged peripheral and cranial mediastinal lymph nodes, left ventricular thickening and cardiac tamponade secondary to pericardial effusion. Fine needle aspiration of the cranial mediastinal lymph node showed pyogranulomatous inflammation with short, thin and poorly septated hyphae. Culture of the aspirate yielded a fungal isolate identified as Inonotus tropicalis based on morphologic features and rRNA gene sequencing. Postmortem examination showed myocardial thickening with multifocal to coalescing, firm, white, ill-defined nodules. Histology confirmed the presence of disseminated fungal infection with extensive myocardial involvement. Inonotus tropicalis is an opportunistic poroid wood-decaying basidiomycete. Infection in this dog was likely the result of chronic immunosuppressive therapy. PMID:26003903

  6. Pericardial Mesothelioma in a Yellow-naped Amazon Parrot (Amazona auropalliata).

    Science.gov (United States)

    McCleery, Brynn; Jones, Michael P; Manasse, Jorden; Johns, Sara; Gompf, Rebecca E; Newman, Shelley

    2015-03-01

    A 37-year-old female yellow-naped Amazon parrot (Amazona auropalliata) was presented with a history of lethargy, inappetence, and decreased vocalizations. On examination, the coelom was moderately distended and palpated fluctuant, and the heart was muffled on auscultation. Coelomic ultrasound, coelomocentesis, and radiographs were performed and revealed an enlarged cardiac silhouette and marked coelomic effusion. Pericardial effusion was confirmed by echocardiography. A well-circumscribed, hyperechoic soft tissue density was observed at the level of the right atrium on initial echocardiography; however, a cardiac mass was not identified by computed tomography scan or repeat echocardiograms. Ultrasound-guided pericardiocentesis was performed under anesthesia, and cytology results were consistent with hemorrhage; no neoplastic cells were identified. A repeat echocardiogram 4 days after pericardiocentesis revealed recurrence of the pericardial effusion. Due to the grave prognosis, the owners declined endoscopic pericardiectomy, and the patient died the following day. On postmortem examination, the pericardial surface of the heart was covered in a white to yellow, multinodular mass layer. Histologic analysis revealed a multinodular mass extending from the atria, running along the epicardium distally, and often extending into the myocardium. Neoplastic cells present in the heart mass and pericardium did not stain with a Churukian-Schenk stain, and thyroglobulin immunohistochemistry was negative. Cytokeratin and vimentin stains showed positive expression in the neoplastic cells within the mass. These results are consistent with a diagnosis of mesothelioma. This is the first report of mesothelioma in a psittacine bird. PMID:25867668

  7. Commentary on: Pericardial Fat is Independently Associated with Human Atrial Fibrillation by Al Chekakie et al.

    Directory of Open Access Journals (Sweden)

    Omar Batal, MD

    2010-10-01

    Full Text Available Obesity is an established risk factor for atrial fibrillation (AF.1 In fact, it has been reported that the increasing prevalence of obesity in the United States could account for up to 60 % of the increasing incidence of age and sex adjusted AF.2 Adipose tissue has been shown to be highly metabolically active and secretes several proinflammatory mediators; however, different fat depots differ in metabolic and inflammatory activity.3 Pericardial fat produces several inflammatory cytokines and is believed to play an important role in cardiovascular pathology, and particularly in coronary artery disease.4-7 There exists increasing evidence that links AF and inflammation. The concentration of serum C-reactive protein (CRP, a marker of systemic inflammation, is increased in patients with AF, and has been associated with the development of new AF as well as AF persistence.8-9 Given the association of AF with central obesity and systemic inflammation, investigating the role of pericardial fat, a local fat depot with high inflammatory potential, is of interest. Al Chekakie et al.10 investigated the association of atrial fibrillation and pericardial fat.

  8. Traumatic abdominal wall hernia in two adults: a case series

    Directory of Open Access Journals (Sweden)

    Agarwal Nitin

    2009-06-01

    Full Text Available Abstract Introduction Traumatic hernia of the abdominal wall is a rare entity. A large proportion of reported cases are in children with a particular type of injury, i.e. from a handlebar injury. In adults, the presentation can vary substantially and the diagnosis is difficult. We present two cases in adults, with widely varying presentations and management. Case presentations A 40-year-old woman from rural north India presented with a low-velocity blunt injury to the lower abdomen. She was attacked by a bull. She had a clinically evident abdominal fascial disruption with intact skin, and was hemodynamically stable. An emergency mesh repair of the defect was performed, and she recovered well. A 38-year-old man from rural north India presented with blunt trauma to the abdomen following a motor vehicle accident. He was stable, with a central abdominal parietal wall swelling and bruising. A computed tomography scan revealed herniation of bowel loops in the area with minor intra-abdominal injuries. A laparotomy, resection-anastomosis of the ischemic bowel, and primary repair of the defect was performed and he recovered well. Conclusion Following blunt abdominal trauma, particularly high-velocity injuries, a high index of suspicion must be reserved for parietal wall swellings, as missed hernias in this setting have a high risk of strangulation. Computed tomography is the best aid to diagnosis. Management of each case needs to be individualized.

  9. MicroRNA profiling of pericardial fluid samples from patients with heart failure.

    Directory of Open Access Journals (Sweden)

    Suvi M Kuosmanen

    Full Text Available Multicellular organisms maintain vital functions through intercellular communication. Release of extracellular vesicles that carry signals to even distant target organs is one way of accomplishing this communication. MicroRNAs can also be secreted from the cells in exosomes and act as paracrine signalling molecules. In addition, microRNAs have been implicated in the pathogenesis of a large number of diseases, including cardiovascular diseases, and are considered as promising candidate biomarkers due to their relative stability and easy quantification from clinical samples. Pericardial fluid contains hormones secreted by the heart and is known to reflect the cardiac function. In this study, we sought to investigate whether pericardial fluid contains microRNAs and if so, whether they could be used to distinguish between different cardiovascular pathologies and disease stages.Pericardial fluid was collected from heart failure patients during open-heart surgery. MicroRNA profiles of altogether 51 patients were measured by quantitative real-time PCR (qPCR using Exiqon human panels I and II. On the average, 256 microRNAs were detected per sample, and 70 microRNAs out of 742 profiled microRNAs were detected in every sample. The five most abundant microRNAs in pericardial fluid were miR-21-5p, miR-451a, miR-125b-5p, let-7b-5p and miR-16-5p. No specific signatures for cardiovascular pathologies or clinically assessed heart failure stages could be detected from the profiles and, overall, microRNA profiles of the samples were found to be very similar despite the heterogeneity in the study population.Measured microRNA profiles did not separate the samples according to the clinical features of the patients. However, several previously identified heart failure marker microRNAs were detected. The pericardial fluid microRNA profile appeared to be a result of an active and selective secretory process indicating that microRNAs may act as paracrine signalling

  10. Diagnosis and treatment of 34 cases of blunt duodenal injuries

    Institute of Scientific and Technical Information of China (English)

    BAO Shi-ting; WANG San-ming

    2007-01-01

    Objective: To summarize the experience on diagnosis and treatment of blunt duodenal injuries, and thus to improve the therapeutic skills. Methods: Clinical data of 34 cases of blunt duodenal injuries admitted to our hospital from 1990 to 2006 were retrospectively analyzed. Results: Among them, 28 cases were cured, 20 cases presented with complications, and 6 cases died. The causes of death were: duodenal or pancreatic fistula in 2 cases, intra- and retroperitoneal infection complicating septicopyemia in 2, disseminated intravascular coagulation in 1 and multiple organ failure in 1. Conclusions: Misdiagnosis and missed diagnosis predispose to happen for blunt duodenal injuries. Early recognition and surgical intervention are critical to a successful rescue.

  11. Traumatic Brain Injury

    Science.gov (United States)

    Traumatic brain injury (TBI) happens when a bump, blow, jolt, or other head injury causes damage to the brain. Every year, millions of people in the U.S. suffer brain injuries. More than half are bad enough that ...

  12. Traumatic events and children

    Science.gov (United States)

    ... over and over are: Physical or emotional abuse Sexual abuse Gang violence War Terrorist events ... Force on Community Preventive Services. The effectiveness of interventions to reduce psychological harm from traumatic events among ...

  13. Understanding Child Traumatic Stress

    Science.gov (United States)

    ... Public Awareness Sustainability Policy Issues Understanding Child Traumatic Stress Page Contents: Responding to Danger When Danger Turns ... malevolence, and human accountability. Back to Top Posttraumatic Stress Responses For reasons that are basic to survival, ...

  14. Traumatic Brain Injury

    Science.gov (United States)

    Traumatic brain injury (TBI) happens when a bump, blow, jolt, or other head injury causes damage to the brain. Every year, millions of people in the U.S. suffer brain injuries. More than half are bad enough that people ...

  15. The effect of posterior pericardiotomy on pericardial effusion and atrial fibrillation after off-pump coronary artery bypass graft.

    Directory of Open Access Journals (Sweden)

    Mahdi Haddadzadeh

    2015-01-01

    Full Text Available The most common type of arrhythmia following coronary artery bypass graft (CABG is atrial fibrillation (AF with an incidence rate of 20-30%. Pericardial effusion is one of the etiologic factors of atrial fibrillation occurring after CABG. Posterior pericardiotomy (PP causes the drainage of blood and fluids from the pericardial space into the pleural space leading to a decreased pericardial effusion. Most of the studies dealing with the occurrence of AF in the surgical operation of CABG have focused on patients undergoing on-pump CABG. The purpose of the present study was to determine the effect of posterior pericardiotomy on pericardial effusion and atrial fibrillation following the off-pump CABG. This study was a clinical trial conducted on 207 patients. The patients were randomly assigned to groups A, and B. Posterior pericardiotomy was performed on the patients in Group A. This was not done on patients in Group B. Following general anesthesia and median sternotomy, the left internal mammary artery (LIMA and saphenous vein were harvested simultaneously. Following the injection of heparin, distal and proximal anastomosis was performed and at the end of surgery, a longitudinal incision with a length of 4 cm was performed parallel and posterior to the left phrenic nerve from the left vein to diaphragm for patients in the pericardiotomy group. 105 patients in the pericardiotomy group and 102 patients in the control group were examined regarding demographic variables, AF incidence, and pericardial effusion. There was no statistically significant correlation between two groups. There was no statistically significant difference between the two groups regarding the rate of AF incidence (P=0.719 and the rate of pericardial effusion (P=1. Posterior pericardiotomy has no effect on postoperative AF incidence and pericardial effusion in patients undergoing the off-pump CABG.

  16. Primary traumatic patellar dislocation

    Directory of Open Access Journals (Sweden)

    Tsai Chun-Hao

    2012-06-01

    Full Text Available Abstract Acute traumatic patellar dislocation is a common injury in the active and young adult populations. MRI of the knee is recommended in all patients who present with acute patellar dislocation. Numerous operative and non-operative methods have been described to treat the injuries; however, the ideal management of the acute traumatic patellar dislocation in young adults is still in debate. This article is intended to review the studies to the subjects of epidemiology, initial examination and management.

  17. Blunt traumatic rupture of the right ventricle, with intrapericardial rupture of the diaphragm: successful surgical repair.

    Science.gov (United States)

    Le Treut, Y P; Herve, L; Cardon, J M; Boutboul, R; Bricot, R

    1981-07-01

    The authors report a case of chest injury causing rupture of the right ventricle and diaphragm, discovered during laparotomy for haemoperitoneum. This type of injury to the heart has rarely been cited in the literature since survival rates are low and the diagnosis often overlooked. PMID:7319634

  18. Traumatic expulsive aniridia after phacoemulsification

    OpenAIRE

    Prabhu Avinash; Nayak Harish; Palimar Prasad

    2007-01-01

    Blunt trauma is usually associated with severe ocular damage particularly in eyes following cataract surgery. Small, self-sealing incision cataract surgery is changing the pattern of presentation of such cases, with relatively favorable outcomes. We describe a case of blunt trauma following phacoemulsification leading to aniridia.

  19. Sharp compared with blunt fascial incision at cesarean delivery

    DEFF Research Database (Denmark)

    Aabakke, Anna J M; Hare, Kristine J; Krebs, Lone;

    2014-01-01

    To compare patient preference for either sharp incision with scissors or blunt manual cleavage of the fascia at cesarean delivery in a randomized controlled trial in which each woman was her own control.......To compare patient preference for either sharp incision with scissors or blunt manual cleavage of the fascia at cesarean delivery in a randomized controlled trial in which each woman was her own control....

  20. Unrecognized blunt tracheal trauma with massive pneumomediastinum and tension pneumothorax

    Directory of Open Access Journals (Sweden)

    Nanda Shetty

    2011-01-01

    Full Text Available Blunt neck trauma with an associated laryngotracheal injury is rare. We report a patient with blunt neck trauma who came to the emergency room and was sent to ward without realizing the seriousness of the situation. He presented later with respiratory distress and an anesthesiologist was called in for emergency airway management. Airway management in such a situation is described in this report.

  1. An Animal Model of Emotional Blunting in Schizophrenia

    OpenAIRE

    Pietersen, Charmaine Y.; Fokko J Bosker; Janine Doorduin; Jongsma, Minke E.; Folkert Postema; Joseph V Haas; Johnson, Michael P; Tineke Koch; Tony Vladusich; den Boer, Johan A.

    2007-01-01

    Schizophrenia is often associated with emotional blunting--the diminished ability to respond to emotionally salient stimuli--particularly those stimuli representative of negative emotional states, such as fear. This disturbance may stem from dysfunction of the amygdala, a brain region involved in fear processing. The present article describes a novel animal model of emotional blunting in schizophrenia. This model involves interfering with normal fear processing (classical conditioning) in rat...

  2. [Blunt abdominal trauma.--analysis of 201 cases (author's transl)].

    Science.gov (United States)

    Pannenborg, G; Wolf, O; Voigtsberger, P

    1978-01-01

    201 blunt abdominal traumata treated clinically at the surgical department of the Medical Academy in Erfurt from 1967 to 1976 are reported: No increase of blunt abdominal traumata within the period of the report in spite of considerable growth of trafficdensity and industrialization could be observed.--The percentage of severe secundary injuries remained approximately constant, too.--Intestinal lesions, combined hepatolienal ruptures caused the highest mortality especially in combination with severe craniocerebral lesions. PMID:685552

  3. Low velocity blunt impacts on composite aircraft structures

    OpenAIRE

    Whisler, Daniel A.

    2009-01-01

    As composites are increasingly used for primary structures in commercial aircrafts, it is necessary to understand damage initiation for composites subject to low velocity impacts from service conditions, maintenance, and other ground equipment mishaps. In particular, collisions with ground vehicles can present a wide area, blunt impact. Therefore, the effects of bluntness of an impactor are of interest as this is related to both the external visual detectability of an impact event, as well as...

  4. The molecular fingerprint of lung inflammation after blunt chest trauma

    OpenAIRE

    Ehrnthaller, Christian; Flierl, Michael; Perl, Mario; Denk, Stephanie; Unnewehr, Heike; Ward, Peter A.; Radermacher, Peter; Ignatius, Anita; Gebhard, Florian; Chinnaiyan, Arul; Huber-Lang, Markus

    2015-01-01

    Background After severe blunt chest trauma, the development of an acute lung injury (ALI) is often associated with severe or even lethal complications. Especially in multiple injured patients after blunt chest trauma ALI/ARDS [acute respiratory distress syndrome (ARDS)] is frequent. However, in the initial posttraumatic phase, inflammatory clinical signs are often not apparent and underlying changes in gene-expression profile are unknown. Methods Therefore, inflammation in lung tissue followi...

  5. Diagnostic and therapeutic results of angiography of blunt abdominal trauma

    International Nuclear Information System (INIS)

    Angiographic findings in blunt abdominal trauma are reviewed. 693 posttraumatic angiograms were performed at the University of Freiburg from 1972-1980. 24% of these patients suffered from blunt abdominal trauma. It could be shown that recently ultrasongraphy and computerized tomography have replaced angiography as screening method. Remaining indications for angiography are primary vascular lesions, uncertain findings of US- and/or C Texamination and documentation of hemorrhage with the possibility of therapeutic intervention. (orig.)

  6. Blunt pancreatic trauma: A persistent diagnostic conundrum?

    Science.gov (United States)

    Kumar, Atin; Panda, Ananya; Gamanagatti, Shivanand

    2016-02-28

    Blunt pancreatic trauma is an uncommon injury but has high morbidity and mortality. In modern era of trauma care, pancreatic trauma remains a persistent challenge to radiologists and surgeons alike. Early detection of pancreatic trauma is essential to prevent subsequent complications. However early pancreatic injury is often subtle on computed tomography (CT) and can be missed unless specifically looked for. Signs of pancreatic injury on CT include laceration, transection, bulky pancreas, heterogeneous enhancement, peripancreatic fluid and signs of pancreatitis. Pan-creatic ductal injury is a vital decision-making parameter as ductal injury is an indication for laparotomy. While lacerations involving more than half of pancreatic parenchyma are suggestive of ductal injury on CT, ductal injuries can be directly assessed on magnetic resonance imaging (MRI) or encoscopic retrograde cholangio-pancreatography. Pancreatic trauma also shows temporal evolution with increase in extent of injury with time. Hence early CT scans may underestimate the extent of injures and sequential imaging with CT or MRI is important in pancreatic trauma. Sequential imaging is also needed for successful non-operative management of pancreatic injury. Accurate early detection on initial CT and adopting a multimodality and sequential imaging strategy can improve outcome in pancreatic trauma. PMID:26981225

  7. A RETROSPECTIVE STUDY OF BLUNT TRAUMA ABDOMEN

    Directory of Open Access Journals (Sweden)

    Kumawat

    2015-07-01

    Full Text Available BACKGROUND: Blunt abdominal trauma is one of the important components of poly - trauma. It requires suspicion, investigation and proper management in time, to avoid morbidity & mortality. AIM: The aim of this retrospective study spanning 5 years w.e.f. Jan, 2010 to December, 2014 in this tertiary care institute of Geetanjali Medical College & Hospital, Udaipur was to find out BTA patients in RTA, fall from height, and assault like injuries. We studied type of injuries, male - female ratio, age group, urban & rural population involvement & their operative & non - operative management. MATERIAL & METHOD S : The study is based on 273 cases of BTA; managed in this institute from admission, investigation, management & possible follow up. Observations are depicted in different tables. RESULT: Liver is most commonly involved organ followed by spleen, kidney & pancreas respectively. Initially solid organ injuries cases where treated by surgery, but than non - operative management are tried in haemostatically stable patients. Hollow visceral injuries were always managed by laparotomy & repair or resection as and when needed . Mortality occurred in 35 patients out 273 patients because of delay to reach hospital or septicemia, renal failure and shock due to multi organ failure. CONCLUSION: Close supervision with sophisticated infrastructure and quick action significantly reduces mortality.

  8. Visual Outcome of Traumatic Cataract at a Tertiary Eye Care Centre in North India: A Prospective Study

    Science.gov (United States)

    Sharma, Ashish Kumar; Srivastava, Jai Prakash; Iqbal, Jawed

    2016-01-01

    Introduction One of the most common presentations of blunt and penetrating ocular trauma is traumatic cataract. It remains a significant cause of visual impairment and physical disability among adults and children. It is associated with various ocular injuries. Aim To evaluate the associated ocular injuries and final outcome of patients with traumatic cataract along with their demographic features and modes of trauma. Materials and Methods A prospective study done in Department of Ophthalmology in M.L.B. Medical college, Jhansi from February 2010 to July 2011. A total of 48 patients diagnosed as a case of traumatic cataract were subjected to a detailed history, systemic and local examination with relevant investigations. Medical or surgical managements were done accordingly. Patients were subsequently followed-up and visual acuity was recorded. Appropriate statistical tests were applied. Results A 54.2% patients sustained penetrating trauma while 45.8% got blunt injury. Out of total, 79% patients were males while 50% were less than 15 years of age. Causative agents were stone, wood items, stick, metal objects etc. Among blunt trauma cases, 64% of the patients had visual acuity 6/18. Anterior segment was more involved as compared to posterior segment. A 38.5% patients had corneal opacity among penetrating injury patients. The interval between trauma and surgery was less than one month among 75% of patients. After three months of surgery, 43.7% patients had visual acuity of >6/18. Conclusion This study provides recent data of patients hospitalized after ocular trauma and diagnosed as a case of traumatic cataract. Traumatic cataract occurs mostly in younger males. Surgical intervention is necessary to improve visual outcome. Good visual outcome was obtained in nearly half of the patients. Traumatic cataract patients can have good visual outcome depending upon proper management. PMID:26894101

  9. Pericardial tamponade and pancytopenia as the first manifestation of mixed connective tissue disorder and its complete reversal with corticosteroids

    Directory of Open Access Journals (Sweden)

    Ankur Jain

    2014-09-01

    Full Text Available We report a case of a 25-year-old lady who presented to our department with complaints of easy fatigability and shortness of breath since one week. She had a history of Raynaud’s phenomenon. Examination revealed scleroderma like skin changes and pericardial friction rub. Investigations revealed high titer of anti-U1 RNP antibodies along with co-existing pancytopenia. Chest x-ray and echocardiography confirmed pericardial tamponade. Patient was diagnosed as having mixed connective tissue disorder (MCTD and she was started on high dose prednisolone, which led to complete reversal of pancytopenia and pericardial tamponade after 1 month of treatment. There are only 6 reported cases of pericardial tamponade in a patient with MCTD, and none of them had pancytopenia. Present case highlights the need to investigate the patient of pericardial tamponade for MCTD, especially in the presence of pancytopenia and relevant clinical history, as prompt treatment with corticosteroids can avoid invasive procedures like pericardiocentesis.

  10. Effects of Nose Bluntness on Stability of Hypersonic Boundary Layers over Blunt Cone

    Science.gov (United States)

    Kara, K.; Balakumar, P.; Kandil, O. A.

    2007-01-01

    Receptivity and stability of hypersonic boundary layers are numerically investigated for boundary layer flows over a 5-degree straight cone at a free-stream Mach number of 6.0. To compute the shock and the interaction of shock with the instability waves, we solve the Navier-Stokes equations in axisymmetric coordinates. The governing equations are solved using the 5th-order accurate weighted essentially non-oscillatory (WENO) scheme for space discretization and using third-order total-variation-diminishing (TVD) Runge-Kutta scheme for time integration. After the mean flow field is computed, disturbances are introduced at the upstream end of the computational domain. Generation of instability waves from leading edge region and receptivity of boundary layer to slow acoustic waves are investigated. Computations are performed for a cone with nose radii of 0.001, 0.05 and 0.10 inches that give Reynolds numbers based on the nose radii ranging from 650 to 130,000. The linear stability results showed that the bluntness has a strong stabilizing effect on the stability of axisymmetric boundary layers. The transition Reynolds number for a cone with the nose Reynolds number of 65,000 is increased by a factor of 1.82 compared to that for a sharp cone. The receptivity coefficient for a sharp cone is about 4.23 and it is very small, approx.10(exp -3), for large bluntness.

  11. Incidental finding of congenital pericardial and mediastinal pleural defect by pneumothorax in an adult

    International Nuclear Information System (INIS)

    Introduction: Congenital pericardial defect (CPD) is an uncommon anomaly. If once cardiac herniation occurs, it threatens life. We report a case of left-sided pneumothorax with consequent protrusion of the heart into left thoracic cavity through not only a large CPD but also congenital pleuropericardium window. Case presentation: A 67-year-old man presenting with sudden-onset left-sided chest pain and slight dyspnea was referred to our hospital. Chest X-ray showed a left lung collapse, and also revealed a pneumopericardium along the right border of the ascending aorta. Subsequent computed tomography (CT) scan revealed that the heart was displaced into the left hemithorax. Thus, we diagnosed the patient with pneumothorax and a defect of the pericardial and mediastinal pleurae. Subsequently, a chest tube was inserted into the left thoracic cavity, and the collapsed lung was promptly inflated. The cardiac position was reinstated within mediastinum as evidenced by follow-up CT scan. The QRS axis on his electrocardiogram (ECG) was altered from 52° to 73°. Together with the cardiac relocation evidenced by the QRS axis shift on ECG and findings of CT, we determined that there was a low potential for complications and opted against surgical repair. Discussion: When the CPD is sufficiently large, surgical intervention is not necessary. The size of the CPD can be assessed not only by CT findings, but the alteration of the QRS axis on ECG also provides useful information whether cardiac herniation can be resolved by the inflated lung. - Highlights: • We reported a case of congenital pericardial defect (CPD) with pneumothorax. • We described how to manage to alleviate life-threatening complications. • The size of CPD was assessed by CT findings and the alteration of QRS axis on ECG

  12. Predictors of Post Pericardiotomy Low Cardiac Output Syndrome in Patients With Pericardial Effusion

    Directory of Open Access Journals (Sweden)

    Sabzi Feridoun

    2015-03-01

    Full Text Available Introduction: Pathological involvement of pericardium by any disease that resulting in effusion may require decompression and pericardiectomy. The current article describes rare patients with effusion who after pericadiectomy and transient hemodynamic improvement rapidly developed progressive heart failure and subsequent multi organ failure.Methods: During periods of five years, 423 patients in our hospital underwent pericardiotomy for decompression of effusion. The clinical characteristics of those patient with postoperative low cardiac output (B group (14 cases recorded and compared with other patients without this postoperative complication (A group by test and X2. Significant variables in invariables (P≤0.1 entered in logistic regression analysis and odd ratio of these significant variables obtained. Results: Idiopathic pericardial effusion, malignancy, renal failure, connective tissue disease, viral pericarditis was found in 125 patients (27%, 105 patients (25.4%, 65 patients (15.6%, 50 (17.1% and 10 (2.4% of patients subsequently. The factors that predict post-operative death in logistic regression analysis were malignancy, radiotherapy, constrictive pericarditis inotropic drug using IABP using, pre-operative EF and pericardial calcification.Conclusion: Certain preoperative variables such as malignancy, radiotherapy, low EF, calcified pericardium and connective tissue disease are associated with POLCOS and post-operative risk of death. This paradoxical response to pericardial decompression may be more frequent than currently appreciated. Its cause may relate to the sudden removal of the chronic external ventricular support from the effusion or thicken pericardium resulting in ventricular dilatation and failure or intra operative myocardial injury due to pericardiectomy of calcified pericardium, radiation and cardiomyopathy.

  13. Continuous Postoperative Pericardial Flushing: A Pilot Study on Safety, Feasibility, and Effect on Blood Loss

    Science.gov (United States)

    Manshanden, Johan S.J.; Gielen, Chantal L.I.; de Borgie, Corianne A.J.M.; Klautz, Robert J.M.; de Mol, Bas A.J.M.; Koolbergen, David R.

    2015-01-01

    Background Prolonged or excessive blood loss is a common complication after cardiac surgery. Blood remnants and clots, remaining in the pericardial space in spite of chest tube drainage, induce high fibrinolytic activity that may contribute to bleeding complications. Continuous postoperative pericardial flushing (CPPF) with an irrigation solution may reduce blood loss by preventing the accumulation of clots. In this pilot study, the safety and feasibility of CPPF were evaluated and the effect on blood loss and other related complications was investigated. Methods Between November 2011 and April 2012 twenty-one adult patients undergoing surgery for congenital heart disease (CHD) received CPPF from sternal closure up to 12 h postoperative. With an inflow Redivac drain that was inserted through one of the chest tube incision holes, an irrigation solution (NaCl 0.9% at 38 °C) was delivered to the pericardial cavity using a volume controlled flushing system. Safety aspects, feasibility issues and complications were registered. The mean actual blood loss in the CPPF group was compared to the mean of a retrospective group (n = 126). Results CPPF was successfully completed in 20 (95.2%) patients, and no method related complications were observed. Feasibility was good in this experimental setting. Patients receiving CPPF showed a 30% (P = 0.038) decrease in mean actual blood loss 12 h postoperatively. Conclusions CPPF after cardiac surgery was found to be safe and feasible in this experimental setting. The clinically relevant effect on blood loss needs to be confirmed in a randomized clinical trial. PMID:26501121

  14. Pediatric Traumatic Brain Injury.

    Science.gov (United States)

    Schaller, Alexandra L; Lakhani, Saquib A; Hsu, Benson S

    2015-10-01

    The purpose of this article is to provide a better understanding of pediatric traumatic brain injury and its management. Within the pediatric age group, ages 1 to 19, injuries are the number one cause of death with traumatic brain injury being involved in almost 50 percent of these cases. This, along with the fact that the medical system spends over $1 billion annually on pediatric traumatic brain injury, makes this issue both timely and relevant to health care providers. Over the course of this article the epidemiology, physiology, pathophysiology, and treatment of pediatric traumatic brain injury will be explored. Emphasis will be placed on the role of the early responder and the immediate interventions that should be considered and/or performed. The management discussed in this article follows the most recent recommendations from the 2012 edition of the Guidelines for the Acute Medical Management of Severe Traumatic Brain Injury in Infants, Children, and Adolescents. Despite the focus of this article, it is important not to lose sight of the fact that an ounce of prevention is worth a pound--or, to be more precise and use the average human's brain measurements, just above three pounds--of cure. PMID:26630835

  15. Facilitating post traumatic growth

    Directory of Open Access Journals (Sweden)

    Cox Helen

    2004-07-01

    Full Text Available Abstract Background Whilst negative responses to traumatic injury have been well documented in the literature, there is a small but growing body of work that identifies posttraumatic growth as a salient feature of this experience. We contribute to this discourse by reporting on the experiences of 13 individuals who were traumatically injured, had undergone extensive rehabilitation and were discharged from formal care. All participants were injured through involvement in a motor vehicle accident, with the exception of one, who was injured through falling off the roof of a house. Methods In this qualitative study, we used an audio-taped in-depth interview with each participant as the means of data collection. Interviews were transcribed verbatim and analysed thematically to determine the participants' unique perspectives on the experience of recovery from traumatic injury. In reporting the findings, all participants' were given a pseudonym to assure their anonymity. Results Most participants indicated that their involvement in a traumatic occurrence was a springboard for growth that enabled them to develop new perspectives on life and living. Conclusion There are a number of contributions that health providers may make to the recovery of individuals who have been traumatically injured to assist them to develop new views of vulnerability and strength, make changes in relationships, and facilitate philosophical, physical and spiritual growth.

  16. Understanding Traumatic Stress in Children

    Science.gov (United States)

    ... here Home 22 Apr 2013 Report Understanding Traumatic Stress in Children Supporting Children and Families After Traumatic ... Adult Learning and the Workforce International Client Services Student Assessment Research and Evaluation Policy, Practice, and Systems ...

  17. TRAUMATIC BRAIN INJURY (TBI) DATABASE

    Science.gov (United States)

    The Traumatic Brain Injury National Data Center (TBINDC) at Kessler Medical Rehabilitation Research and Education Center is the coordinating center for the research and dissemination efforts of the Traumatic Brain Injury Model Systems (TBIMS) program funded by the National Instit...

  18. Postpericardiectomy syndrome in a patient with radiation-induced pericardial effusion.

    Science.gov (United States)

    Ferrannini, E; Pentimone, F

    1983-01-01

    A 30-year-old man with mild exertional dyspnea of recent (2 months) onset was found to have a massive pericardial effusion. The patient had received mediastinal irradiation for Hodgkin's disease over 9 years previously. No evidence of recurrent lymphoma or other causes of pericarditis could be found. Following subtotal pericardiectomy, the patient developed a syndrome characterized by precordial discomfort, low-grade fever, tachycardia, and friction rubs. The electrocardiogram, normal preoperatively, showed diffusely negative T waves. Antimyocardial antibodies appeared in the serum. The syndrome, a hitherto unrecognized sequela of pericardiectomy, is interpreted as a mediastinoepicarditis, of possibly autoimmune origin. PMID:6616511

  19. Adjuvant Pericardial Sac Restraining in Heart Failure Treatment. A Medical Hypothesis Illustrated by a Case Report.

    Science.gov (United States)

    Evora, Paulo Roberto Barbosa; Romano, Minna Moreira D; Gali, Luis Gustavo; Schmidt, André; Rodrigues, Alfredo José

    2016-02-01

    Ventricular constraint therapy has been used to prevent and reverse the progression of heart failure in ischemic and nonischemic cardiomyopathies. We hypothesized that ventricular restraint should be tried by closing the pericardium that was previously opened following left ventricle topographical projection. The surgical technique presentation is illustrated by a remarkable 13-year outcome of one patient with dilated cardiomyopathy treated surgically by mitral prosthesis, Cox/Maze III surgery to treat atrial fibrillation, and associated to the ventricular constraint using the patient's own pericardium. The ventricular pericardial restraint role is unclear, since the patient had multiple corrections that could be responsible for the good outcome; however it is viable deserving investigations. PMID:27074278

  20. Biventricular heart failure secondary to a pericardial cystic mass: case report

    Energy Technology Data Exchange (ETDEWEB)

    Nizzero, A. [Sudbury Regional Hospital, Dept. of Diagnostic Imaging, Sudbury, Ontario (Canada); Dobranowski, J. [St. Joseph' s Hospital, Dept. of Radiology, Hamilton, Ontario (Canada); Tanser, P. [St. Joseph' s Hospital, Dept. of Cardiology, Hamilton, Ontario (Canada)

    2000-07-01

    Cystic masses of the pericardium causing symptoms due to cardiac compression are very unusual. Such cysts may be congenital, or they may occur secondary to inflammatory processes or hemorrhage, similar to cysts seen in the pleura or peritoneum. Echocardiography, computed tomography (CT) and magnetic resonance imaging (MRI) are useful for noninvasive investigation of the pericardium, although in the remote past, definitive diagnosis was possible only with thoracotomy. We present a case of biventricular cardiac failure secondary to a calcified pericardial cystic mass in a patient with constrictive pericarditis. Because of the extensive calcification, echocardiography was not helpful. CT and MRI allowed excellent delineation of the nature and effects of this abnormality. (author)

  1. Post-traumatic Stress Disorder

    OpenAIRE

    M Yadollahie; Javidi, H.

    2011-01-01

    Unexpected extreme sudden traumatic stressor may cause post-traumatic stress disorder (PTSD). Important traumatic events include war, violent personal assault (e.g., sexual assault, and physical attack), being taken hostage or kidnapped, confinement as a prisoner of war, torture, terrorist attack, severe car accidents, and natural disasters. In childhood age sexual abuse or witnessing serious injuries or unexpected death of a beloved one are among important traumatic events.PTSD can be catego...

  2. GLAUCOMA FOLLOWING BLUNT TRAUMA : AN EPIDEMIOLOGICAL AND CLINICAL STUDY

    Directory of Open Access Journals (Sweden)

    Purvi R

    2014-03-01

    Full Text Available AIMS: To study the demographic profile, clinical picture, treatment modalities and long term follow up of patients suffering from glaucoma developing after blunt trauma. MATERIALS AND METHODS: This was a prospective study over one year in which 75 eyes, newly diagnosed or referred with post traumatic glaucoma to M & J Institute of Ophthalmology were studied. All cases underwent thorough eye examination. Treatment was individualized and instituted. RESULTS: Patients ranged from 1 - 70 years with 32 patients (42.66% below 30 years of age. 61 patients (81.33% were males. 66.65% were students, laborers or housewives, with laborers topping the charts in vulnerability. In 46 cases (61.33%, left eye was affected, while in 29 pts. (38.66% right eye was affected. In 54.66% of cases, trauma was caused by stone, wooden stick or ball. Others included fist, firecracker, iron rod, handle, belt.16% patients presented with IOP in the normal range, 38 (50.66% patients had IOP in the range of 21-30 mm Hg, whereas 16 (21.33% patients had IOP more than 40 mm Hg. Within 1 week of instituting treatment, 41 (54.66% had IOP ≤ 20 mm Hg and only 3 patients had IOP more than 30 mm Hg. However, 70 (93.33% patients had IOP ≤ 20 mm Hg by the end of 6 months and all the patients were in this range after 6 months. On slit lamp examination, corneal edema, traumatic mydriasis and sphincter tears were seen in 32 patients each. 12 patients had hyphema and 19 patients had lens dislocated either into vitreous or into the anterior chamber. Iridodialysis was seen in 5 patients. Other findings included cataract, posterior synechiae, subluxation of lens and tobacco dusting. 57 (76% patients had vision less than 6/60, however after an interval of more than 6 months, 28 (37% patients had vision less than 3/60. The number of patients having vision ≥ 6/12 rose from 5 at initial presentation to 15 in follow-up more than 6 months. Disc changes could be assessed by ophthalmoscopy in 37

  3. Vicarious traumatization: concept analysis.

    Science.gov (United States)

    Tabor, Pamela Diane

    2011-12-01

    There is growing knowledge of the effects of stress on professionals, including various negative symptoms that may mirror the biopsychosocial effects exhibited by the victims of trauma. Multiple concepts including burn out, compassion fatigue, post-traumatic stress disorder (PTSD), and secondary traumatic stress, are terms that have been incorrectly interchanged with the term vicarious traumatization (VT). Clarity of vicarious victimization and understanding contributing factors is imperative in order to facilitate future research and implement timely and effective interventions, as well as sculpt evidence based practice. This concept anaylsis, complete with a concept map, discusses VT; related terminology; symptomology; prevention and relevant interventions; and discusses opportunities for personal/professional growth for nurses and especially forensic nurses working with victims of violence. PMID:22123041

  4. Blunt urogenital trauma in prepubescent female patients: more than meets the eye!

    Science.gov (United States)

    Lynch, J M; Gardner, M J; Albanese, C T

    1995-12-01

    Blunt traumatic injury to the urogenital region in the prepubescent girl is commonly evaluated in pediatric emergency departments (ED). The purpose of this study is: 1) to establish recommendations for an accurate, painless (both physically and psychologically), and timely diagnosis, and 2) to determine whether the ED examination can accurately determine the extent of the injury. Over a 24-month period (January 1991 through December 1992), 22 girls with blunt trauma to the urogenital region (mean age 5.7 years, range 2-9 years) were retrospectively evaluated. Initial ED evaluations were by both an emergency physician and a pediatric surgeon. All 22 patients underwent an examination under anesthesia (EUA) in the operating room to evaluate the extent of the injury and to repair the injury as needed. Follow-up was obtained in all patients and averaged 18 months. The findings at EUA demonstrated a significant disagreement with the preoperative ED evaluation. In only five patients was there agreement between the preoperative ED assessment and the findings during the EUA (24% concurrence). Thus, 16 patients (76%) had injuries of greater extent than was appreciated during the preoperative examination in the ED. Partial or complete disruption of the perianal sphincters occurred in six patients (27%) and was unrecognized preoperatively in each. Twenty-one of the 22 patients required suture repair of lacerations, the remaining patient did not require surgical therapy. Three patients had contusions or lacerations to the urethral area requiring repair and/or prolonged bladder catheter drainage for two to 14 days (average seven days). The average hospital stay was 19.3 hours. There were three minor wound complications following surgery: two required repeat EUA with suturing or cauterization, and one required no further therapy. This study clearly demonstrates that the ED examination, by both emergency physicians and pediatric surgeons, of young girls who have suffered blunt

  5. Multidetector CT findings of bowel Transection in blunt abdominal trauma

    International Nuclear Information System (INIS)

    Though a number of CT findings of bowel and mesenteric injuries in blunt abdominal trauma are described in literature, no studies on the specific CT signs of a transected bowel have been published. In the present study we describe the incidence and new CT signs of bowel transection in blunt abdominal trauma. We investigated the incidence of bowel transection in 513 patients admitted for blunt abdominal trauma who underwent multidetector CT (MDCT). The MDCT findings of 8 patients with a surgically proven complete bowel transection were assessed retrospectively. We report novel CT signs that are unique for transection, such as complete cutoff sign (transection of bowel loop), Janus sign (abnormal dual bowel wall enhancement, both increased and decreased), and fecal spillage. The incidence of bowel transection in blunt abdominal trauma was 1.56%. In eight cases of bowel transection, percentage of CT signs unique for bowel transection were as follows: complete cutoff in 8 (100%), Janus sign in 6 (100%, excluding duodenal injury), and fecal spillage in 2 (25%). The combination of complete cutoff and Janus sign were highly specific findings in patients with bowel transection. Complete cut off and Janus sign are the unique CT findings to help detect bowel transection in blunt abdominal trauma and recognition of these findings enables an accurate and prompt diagnosis for emergency laparotomy leading to reduced mortality and morbidity.

  6. Multidetector CT findings of bowel Transection in blunt abdominal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Hyun Suk; Woo, Ji Young; Hong, Hye Suk; Park, Mee Hyun; Yang, Ik; Lee, Yul; Jung, Ah Young; Hwang, Ji Young [Dept. of Radiology, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of); Ha, Hong Il [Dept. of Radiology, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of)

    2013-08-15

    Though a number of CT findings of bowel and mesenteric injuries in blunt abdominal trauma are described in literature, no studies on the specific CT signs of a transected bowel have been published. In the present study we describe the incidence and new CT signs of bowel transection in blunt abdominal trauma. We investigated the incidence of bowel transection in 513 patients admitted for blunt abdominal trauma who underwent multidetector CT (MDCT). The MDCT findings of 8 patients with a surgically proven complete bowel transection were assessed retrospectively. We report novel CT signs that are unique for transection, such as complete cutoff sign (transection of bowel loop), Janus sign (abnormal dual bowel wall enhancement, both increased and decreased), and fecal spillage. The incidence of bowel transection in blunt abdominal trauma was 1.56%. In eight cases of bowel transection, percentage of CT signs unique for bowel transection were as follows: complete cutoff in 8 (100%), Janus sign in 6 (100%, excluding duodenal injury), and fecal spillage in 2 (25%). The combination of complete cutoff and Janus sign were highly specific findings in patients with bowel transection. Complete cut off and Janus sign are the unique CT findings to help detect bowel transection in blunt abdominal trauma and recognition of these findings enables an accurate and prompt diagnosis for emergency laparotomy leading to reduced mortality and morbidity.

  7. Effects of colchicine on pericardial diseases: a review of the literature and current evidence.

    Science.gov (United States)

    Shah, Syed Raza; Alweis, Richard; Shah, Syed Arbab; Arshad, Mohammad Hussham; Manji, Adil Al-Karim; Arfeen, Arham Amir; Javed, Maheen; Shujauddin, Syed Muhammad; Irfan, Rida; Shabbir, Sakina; Shaikh, Shehryar

    2016-01-01

    Colchicine, extracted from the colchicum autumnale plant, used by the ancient Greeks more than 20 centuries ago, is one of the most ancient drugs still prescribed even today. The major mechanism of action is binding to microtubules thereby interfering with mitosis and subsequent modulation of polymorphonuclear leukocyte function. Colchicine has long been of interest in the treatment of cardiovascular disease; however, its efficacy and safety profile for specific conditions have been variably established in the literature. In the subset of pericardial diseases, colchicine has been shown to be effective in recurrent pericarditis and post-pericardiotomy syndrome (PPS). The future course of treatment and management will therefore highly depend on the results of the ongoing large randomized placebo-controlled clinical trial to evaluate the efficacy and safety of colchicine for the primary prevention of several postoperative complications and in the perioperative period. Also, given the positive preliminary outcomes of colchicine usage in pericardial effusions, the future therapeutical use of colchicine looks promising. Further study is needed to clarify its role in these disease states, as well as explore other its role in other cardiovascular conditions. PMID:27406462

  8. Effects of colchicine on pericardial diseases: a review of the literature and current evidence

    Directory of Open Access Journals (Sweden)

    Syed Raza Shah

    2016-07-01

    Full Text Available Colchicine, extracted from the colchicum autumnale plant, used by the ancient Greeks more than 20 centuries ago, is one of the most ancient drugs still prescribed even today. The major mechanism of action is binding to microtubules thereby interfering with mitosis and subsequent modulation of polymorphonuclear leukocyte function. Colchicine has long been of interest in the treatment of cardiovascular disease; however, its efficacy and safety profile for specific conditions have been variably established in the literature. In the subset of pericardial diseases, colchicine has been shown to be effective in recurrent pericarditis and post-pericardiotomy syndrome (PPS. The future course of treatment and management will therefore highly depend on the results of the ongoing large randomized placebo-controlled clinical trial to evaluate the efficacy and safety of colchicine for the primary prevention of several postoperative complications and in the perioperative period. Also, given the positive preliminary outcomes of colchicine usage in pericardial effusions, the future therapeutical use of colchicine looks promising. Further study is needed to clarify its role in these disease states, as well as explore other its role in other cardiovascular conditions.

  9. Idiopathic pericardial effusion in 2 year old labrador managed with ultrasound-guided pericardiocentesis: Case report

    Directory of Open Access Journals (Sweden)

    JB Adeyanju

    2012-06-01

    Full Text Available A two-year old, 38kg-wt male Labrador was presented for management because of progressive exercise intolerance. At presentation, rectal temperature was 38.5oC, pulse rate was135 beats per minute (but weak. There was ascites along with oedema of the extremities. The heart sound was muffled and pulsus paradoxus was very mild. The patient was well hydrated. Thoracic radiography revealed a globoid shaped heart occupying most of the equatorial thoracic volume; there was loss of details of cardiac silhouette and there was dorsal deviation of trachea at carina. Ultrasonography revealed a distinct epicardium, pericardium and a very wide anechoic space in between. Blood picture was within normal findings. Idiopathic chronic pericardial effusion was diagnosed. Ultrasound-guided pericardiocentesis was carried out using a 16 gauge over the needle catheter attached to a 3-way stopcock and a 20mls syringe; about 65mls of clear effusate was aspirated. Laboratory analysis of the effusate revealed that it was a transudate. The patient was placed on 3mg/kg furosemide, twice daily for 5 days and the patient returned to gradual exercise during hospitalization. Oedema of the extremities and ascities decreased, the appetite improved and the dog became more active. Thoracic radiography fourth week post pericardiocentesis revealed a normal cardiac silhouette. The cause of pericardial effusion was not known.

  10. A blunt chest trauma causing left anterior descending artery dissection and acute myocardial infarction treated by deferred angioplasty

    Directory of Open Access Journals (Sweden)

    Rafid Fayadh Al-Aqeedi

    2011-01-01

    Full Text Available Traumatic coronary artery dissection is an uncommon cause of acute myocardial infarction (AMI. We report a case of blunt chest trauma resulting from a motorcycle collision causing ostial dissection of the left anterior descending (LAD artery in a 31-year-old previously healthy male. The patient also suffered from compound comminuted fractures of the humerus and ulna and severe liver laceration, which hampered both percutaneous and surgical acute revasularization. After a stormy hospital course, a bare metal stent was implanted to seal the LAD artery dissection. The patient was discharged in a stable condition and was followed-up for rehabilitation. This case report underscores the multidisciplinary approach in facing challenges encountered after rare sequelae of chest trauma.

  11. Occult Mediastinal Great Vessel Trauma: The Value of Aortography Performed During Angiographic Screening for Blunt Cervical Vascular Trauma

    International Nuclear Information System (INIS)

    Purpose. To determine the value of aortography in the assessment of occult aortic and great vessel injuries when routinely performed during screening angiography for blunt cerebrovascular injury (BCVI). Methods. One hundred and one consecutive patients who received both aortography and screening four-vessel angiography over 4 years were identified retrospectively. Angiograms for these patients were evaluated, and the incidence of occult mediastinal vascular injury was determined. Results. Of the 101 patients, 6 (6%) had angiographically documented traumatic aortic injuries. Of these 6 patients, one injury (17%) was unsuspected prior to angiography. Four of the 6 (67%) also had BCVI. One additional patient also had an injury to a branch of the subclavian artery. Conclusion. Routine aortography during screening angiography for BCVI is not warranted due to the low incidence (1%) of occult mediastinal arterial injury. However, in the setting of a BCVI screening study and no CT scan of the chest, aortography may be advantageous

  12. Traumatic Brain Injury (TBI)

    Science.gov (United States)

    ... A. (2008). Mild traumatic brain injury in U.S. soldiers returning from Iraq. New England Journal of Medicine, 358, 453–463. ... and Spotlights U.S. hospitals miss followup for suspected child abuse Q&A with NICHD Acting Director Catherine ...

  13. Severe Traumatic Brain Injury

    Science.gov (United States)

    ... inflicted traumatic brain injury (ITBI), is a leading cause of child maltreatment deaths in the United States. Meeting the ... Awareness Additional Prevention Resources Childhood Injuries Concussion in Children and Teens Injuries from Violence Injuries from Motor Vehicle Crashes Teen Driver Safety ...

  14. Transcatheter arterial embolization for traumatic bleeding control

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Choon Wook; Lee, Sang Kwon; Suh, Kyung Jin; Kim, Tae Heon; Kim, Yong Joo; Kang, Duck Sik [Kyungpook National University College of Medicine, Taegu (Korea, Republic of)

    1989-04-15

    Angiography is essential for the detection of bleeding vessels in traumatic vascular injury. Immediately after the diagnosis, transcatheter embolization can be performed for the control of bleeding effectively and easily with proper use of embolic materials. Transcatheter embolization is believed to be the treatment of choice when emergency control is needed, where surgical approach is difficult and in those who are poor candidate for surgery. We have tried bleeding control in 18 cases of trauma over recent 4 years. The results were as follows; 1. Causes of bleeding(cases): Blunt or penetrating trauma (10), latrogenic trauma (8), (Postoperative (5), Needle biopsy (2), Percutaneous hepatic procedure (1)) 2. Embolized vessels: Renal artery branches (8), Hepatic artery branches (2), Arteries supplying chest wall (2), External carotid artery branches (3), Internal carotid artery (1), Circumflex humeral artery (1), Internal iliac artery branches (1). 3. Embolic agents: Gelfoam cubes (16), Stainless steel coils (3), Detachable latex balloon (1). 4. Successful bleeding control was achieved in 17 cases and reduction of the amount of bleeding in one case without significant complications.

  15. Isolated common femoral artery injury caused by blunt trauma.

    Science.gov (United States)

    Avaro, J P; Biance, N; Savoie, P H; Peycru, T; Bonnet, P M; Balandraud, P

    2008-01-01

    The authors report an isolated common femoral artery injury caused by blunt trauma with dissection and secondary ischaemia. A 21-year-old man was admitted to hospital after being stabbed during acute alcoholic intoxication. He presented with a stab wound on the left leg and blunt trauma in the right groin. The surgical exploration of the left-sided wound did not disclose any vascular injury. After a 12-hour period of observation, the patient was discharged. Six hours later, he came back with severe ischaemia on the right leg caused by a femoral artery dissection. The patient underwent surgical revascularization, and fully recovered. Isolated artery blunt trauma is a rare event. In this observation, the absence of early symptoms resulted in delayed diagnosis. PMID:19241930

  16. 第2例:慢性持续性大量心包积液%Chronic continuous massive pericardial effusion

    Institute of Scientific and Technical Information of China (English)

    黄樱硕; 孙颖; 邢云利; 肖瑶; 王宇朋; 唐梅; 李敏; 王翠英

    2012-01-01

    A 77-year-old man was admitted to our hospital at July 5th,2010 with an unexplained massive pericardial effusion for 10 years.With dyspnea for one month and normal vital signs without pulsus paradoxus,other physical examination included a small amount of moist rale,normal heart sounds,jugular vein engorgement,positive hepatojugular reflux,hepatosplenomegaly and pitting edema of the extremities.The patient had a complex past history with lymph node tuberculosis,primary artertial hypertension,polycythernia vera,chronic renal insufficiency and hypothyroidism (Hashimoto's thyroiditis),and moreover,received a high dose radiation of 31p in 1967. Family history is negative.The patient had no cardiac tamponade or pericardial constriction during 10 years,he received pericardiocentesis twice,and pericardial effusion was exudative with a high proportion of monocyte.There was no evidences of tuberculosis infection,hypothyroidism,malignant tumor,severe heart failure,uremia,trauma,severe bacterial or fungus infection,chronic myeloid leukemia or bone marrow fibrosis during the admission. The patient refused anti tuberculosis,indwelling catheter drainage or surgical therapy.In this rare case,the aetiology of chronic massive pericardial effusion is most probably chronic idiopathic recurrent pericarditis.

  17. Pericardial effusion in a diabetic patient with prostatic abscess; Derrame pericardico associado a abscesso prostatico em paciente diabetico

    Energy Technology Data Exchange (ETDEWEB)

    Omais, Ali Kassen; Oliveira, Julio Cesar; Tenuta, Marcos de Thadeu; Marchese, Miriam; Ricca, Rene A. Mattos; Tenuta, Maria Carolina Antunes de Oliveira, E-mail: aliomais@yahoo.com [Hospital Geral Universitario (HGU/UNIC), Cuiaba, MT (Brazil); Chauchar, Fause; Cardoso Junior, Valdiro Jose; Carvalho, Valdinei Vieira de [Centro de Cardiologia, Cuiaba, MT (Brazil)

    2009-04-15

    Purulent pericarditis is a rare and potentially fatal disease. Its diagnosis and treatment is difficult. An aggressive antibiotic treatment and pericardial drainage are essentials for the treatment of purulent pericarditis. We report an unusual case of a diabetic patient with purulent pericarditis and prostatic abscess with good evolution after appropriate treatment. (author)

  18. The alterations of plasma ET-1 and NO post selective pericardial devascularization in patients with hepatic portal hypertension

    International Nuclear Information System (INIS)

    Objective: To investigate the alterations of plasma endothelin-1 (ET-1) and nitric oxide (NO) post the selective pericardial devascularization in patients with hepatic portal hypertension,and to investigate the relationship between such alterations with illness and therapeutic effects. Methods: Before treatment,plasma ET-1 and NO contents were determined by radioimmunoassay (RIA) and Griss method respectively in 92 patients with hepatic portal hypertension. One day and three weeks after operation, 66 operated cases with selective pericardial devascularization in patients with hepatic protal hypertension were also determined the levels of plasma ET-1 and NO with RIA. Results: The levels of plasma ET-1 and NO were increased in 92 patients with hepatic portal hypertension, and which closely related to the stage of illness. Post effective selective pericardial devascularization the high levels of plasma ET-1 and No were improved and were closely returned to normal after 3 week's. Conclusion: Clinical detection of plasma ET-1 and NO levels were useful for assessment of the therapeutic effects of selective pericardial devascularization in patients with hepatic portal hypertension. (authors)

  19. [Progressive systemic sclerosis associated with massive pleural and pericardial effusion in a 90-year-old woman].

    Science.gov (United States)

    Hiramatsu, K; Takeda, N; Okumura, S; Takuno, H; Yasuda, K

    1996-07-01

    A 90-year-old woman was admitted to our hospital in December 1993 because of dyspnea on exertion and malaise. She had been well until October 1993, when she first noticed Raynaud's phenomenon, skin tightening, digital ulceration and scarring of her hands. On physical examination, generalized edema was found, along with acrosclerosis with contracture, especially in the fingers, wrists, and elbows. Inspiratory crackles were noted. A roentgenogram of the chest and an echocardiogram revealed pulmonary fibrosis, pulmonary congestion, and massive pleural and pericardial effusions. The pleural effusion was a transudate. Progressive systemic sclerosis was diagnosed, and furosemide and isosorbide were given. The edema and pulmonary congestion resolved, but the pleural and pericardial effusions did not. Prednisolone was given, which reduced the pleural effusion but not the pericardial effusin. The pleura and the pericardium are not usually involved in progressive systemic sclerosis, and this disease rarely occurs in patients over 70 years old. To the best of our knowledge, this was one of the oldest patients with progressive systemic sclerosis. The combination of massive pleural and pericardial effusions, and the advanced age of onset make the present case unusual. PMID:8890609

  20. Sanguineous Pericardial Effusion and Cardiac Tamponade in the Setting of Graves' Disease: Report of a Case and Review of Previously Reported Cases

    Science.gov (United States)

    2016-01-01

    Introduction. Pericardial effusion in the setting of hyperthyroidism is rare. We present a patient with Graves' disease who developed a sanguineous pericardial effusion and cardiac tamponade. Case Description. A 76-year-old man presenting with fatigue was diagnosed with Graves' disease and treated with methimazole. Two months later, he was hospitalized for uncontrolled atrial fibrillation. Electrocardiography showed diffuse low voltage and atrial fibrillation with rapid ventricular rate. Chest radiograph revealed an enlarged cardiac silhouette and left-sided pleural effusion. Thyroid stimulating hormone was undetectable, and free thyroxine was elevated. Diltiazem and heparin were started, and methimazole was increased. Transthoracic echocardiography revealed a large pericardial effusion with cardiac tamponade physiology. Pericardiocentesis obtained 1,050 mL of sanguineous fluid. The patient progressed to thyroid storm, treated with propylthiouracil, potassium iodine, hydrocortisone, and cholestyramine. Cultures and cytology of the pericardial fluid were negative. Thyroid hormone markers progressively normalized, and he improved clinically and was discharged. Discussion. We found 10 previously reported cases of pericardial effusions in the setting of hyperthyroidism. Heparin use may have contributed to the sanguineous nature of our patient's pericardial effusion, but other reported cases occurred without anticoagulation. Sanguineous and nonsanguineous pericardial effusions and cardiac tamponade may be due to hyperthyroidism.

  1. Quantification of echodensities in tuberculous pericardial effusion using fractal geometry: a proof of concept study

    Directory of Open Access Journals (Sweden)

    Ntsekhe Mpiko

    2012-07-01

    Full Text Available Abstract Background The purpose of this study was to quantify the heterogeneous distribution of echodensities in the pericardial fluid of patients with tuberculous pericarditis using echocardiography and fractal analysis, and to determine whether there were differences in the fractal dimensions of effusive-constrictive and effusive non-constrictive disease. Methods We used fractal geometry to quantify the echocardiographic densities in patients who were enrolled in the Investigation of the Management of Pericarditis in Africa (IMPI Africa Registry. Sub-costal and four chamber images were included in the analysis if a minimum of two clearly identified fibrin strands were present and the quality of the images were of a standard which allowed for accurate measurement of the fractal dimension. The fractal dimension was calculated as follows: Df = limlog N(s/[log (l/s], where Df is the box counting fractal dimension of the fibrin strand, s is the side length of the box and N(s is the smallest number of boxes of side length s to cover the outline of the object being measured. We compared the fractal dimension of echocardiographic findings in patients with effusive constrictive pericarditis to effusive non-constrictive pericardial effusion using the non-parametric Mann–Whitney test. Results Of the 14 echocardiographs from 14 participants that were selected for the study, 42.8% (6/14 of images were subcostal views while 57.1% (8/14 were 4-chamber views. Eight of the patients had tuberculous effusive constrictive pericarditis while 6 had tuberculous effusive non-constrictive pericarditis. The mean fractal dimension Df was 1.325 with a standard deviation (SD of 0.146. The measured fibrin strand dimension exceeded the topological dimension in all the images over the entire range of grid scales with a correlation coefficient (r2 greater than 0.8 in the majority. The fractal dimension of echodensities was 1.359 ± 0.199 in effusive constrictive

  2. A traumatic superficial temporal artery aneurysm after a bicycle accident

    Science.gov (United States)

    Veen, Egbert J.D.; Poelmann, Floris B.; IJpma, Frank F.A.

    2014-01-01

    A male cyclist presented with a swelling on the forehead. Six weeks before, he fell of his bike and smashed his head on the ground while wearing a helmet. A smooth lump of 1 cm had evolved on the temporal side of his forehead in a few weeks. Duplex ultrasonography demonstrated a dilated vessel with a minor defect in the luminal wall. Surgical exploration revealed an aneurysm of the superficial temporal artery (STA). The aneurysm was surgically removed and the patient recovered uneventfully. Owing to its superficial course, the STA is vulnerable to blunt head trauma. Traumatic aneurysms of the STA should be a differential diagnostic consideration in patients with a history of trauma and a swelling on their head. PMID:25352578

  3. A traumatic superficial temporal artery aneurysm after a bicycle accident.

    Science.gov (United States)

    Veen, Egbert J D; Poelmann, Floris B; IJpma, Frank F A

    2014-01-01

    A male cyclist presented with a swelling on the forehead. Six weeks before, he fell of his bike and smashed his head on the ground while wearing a helmet. A smooth lump of 1 cm had evolved on the temporal side of his forehead in a few weeks. Duplex ultrasonography demonstrated a dilated vessel with a minor defect in the luminal wall. Surgical exploration revealed an aneurysm of the superficial temporal artery (STA). The aneurysm was surgically removed and the patient recovered uneventfully. Owing to its superficial course, the STA is vulnerable to blunt head trauma. Traumatic aneurysms of the STA should be a differential diagnostic consideration in patients with a history of trauma and a swelling on their head. PMID:25352578

  4. Blunt cerebrovascular injury in rugby and other contact sports: case report and review of the literature.

    Science.gov (United States)

    Cuellar, Trajan A; Lottenberg, Lawrence; Moore, Frederick A

    2014-01-01

    Contact sports have long been a part of human existence. The two earliest recorded organized contact games, both of which still exist, include Royal Shrovetide Football played since the 12(th) century in England and Caid played since 1308 AD in Ireland. Rugby is the premier contact sport played throughout the world with the very popular derivative American football being the premier contact sport of the North American continent. American football in the USA has on average 1,205,037 players at the high school and collegiate level per year while rugby in the USA boasts a playing enrollment of 457,983 at all levels. Recent media have highlighted injury in the context of competitive contact sports including their long-term sequelae such as chronic traumatic encephalopathy (CTE) that had previously been underappreciated. Blunt cerebrovascular injury (BCVI) has become a recognized injury pattern for trauma; however, a paucity of data regarding this injury can be found in the sports trauma literature. We present a case of an international level scrum-half playing Rugby Union at club level for a local non-professional team, in which a player sustained a fatal BCVI followed by a discussion of the literature surrounding sport related BCVI. PMID:24872841

  5. [Rupture of the interventricular septum after the blunt trauma of thorax].

    Science.gov (United States)

    Smejkal, K; Parízková, R; Harrer, J; Lukes, A; Koudelka, J; Zvák, I

    2008-02-01

    Authors present the case of little patient with the dissection, pseudoaneurysm and finally a rupture of the interventricular septum after the blunt thracic injury. The patient was smitten as a pedestrian by a car and during the whole period of her stay in the hospital she was showing signs of circulatory instability. Due to the current intraabdominal injuries this circulatory decompensation was first assigned to hemoperitoneum, for which the girl was operated on about 3 hours after admission. Nevertheless, even after the abdminal cavity check, after the treatment of supreficial liver lacerations and intensive volume resuscitation the patient showed signs of insufficiency. Diagnosis was finally determined on the base of the transthoracic echocardiography (TTE), which proved the traumatic rupture of interventricular septum. The operation followed correcting the defect, which was performed with a good result according to the TTE postoperatively. Nevertheless, 27 hours after the admission the patient died due to the electromechanical dissociation. In the discussion the authors then evoke a number of papers concerning the same topic. PMID:18380159

  6. A review of computerized tomography in blunt abdominal trauma at Christchurch Hospital

    International Nuclear Information System (INIS)

    A review was undertaken of computerized tomography (CT) of the abdomen, performed between March 1993 and December 1994 for blunt abdominal trauma at Christchurch Hospital. CT findings were correlated with the clinical outcome. The outcome was either recovery from an abdominal point of view with or without laparotomy, or post mortem. A total of 116 CTs were reviewed, of which 76 were normal. CT was highly sensitive and specific for a variety of abdominal traumatic lesions. there were 1 false positive and 4 false negatives (only 2 of these significant). There was 1 non-therapeutic laparotomy based on CT findings. There was only 1 case of delayed treatment based on CT results. Three patients had unexplained findings of pneumoperitoneum. Care should be taken when interpreting the presence of free intraperitoneal air on CT scan. The possibility of missed bowel perforation should be considered, especially in the presence of free intra-abdominal fluid and no solid organ injury to account for it. CT scans are useful in the conservative management of solid organ injuries. 15 refs., 1 tab., 1 fig

  7. Pericardial effusion of HIV-infected patients - results of a prospective multicenter cohort study in the era of antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Lind A

    2011-11-01

    Full Text Available Abstract Background Patients with human immunodeficiency virus (HIV infection have an increased risk of cardiovascular diseases. Previous publications described pericardial effusion as one of the most common HlV-associated cardiac affiliations. The aim of the current study was to investigate if pericardial effusion still has a relevant meaning of HIV-infected patients in the era of antiretroviral therapy. Methods The HIV-HEART (HIV-infection and HEART disease study is a cardiology driven, prospective and multicenter cohort study. Outpatients with a known HIV-infection were recruited during a 20 month period in a consecutive manner from September 2004 to May 2006. The study comprehends classic parameters of HIV-infection, comprising CD4-cell count (cluster of differentiation and virus load, as well as non-invasive tests of cardiac diseases, including a thorough transthoracic echocardiography. Results 802 HIV-infected patients (female: 16.6% with a mean age of 44.2 ± 10.3 years, were included. Duration of HIV-infection since initial diagnosis was 7.6 ± 5.8 years. Of all participants, 85.2% received antiretroviral therapy. Virus load was detectable in 34.4% and CD4 - cell count was in 12.4% less than 200 cells/μL. Pericardial effusions were present in only two patients of the analysed population. None of the participants had signs of a relevant cardiovascular impairment by pericardial effusion. Conclusions Our results demonstrate that the era of antiretroviral therapy goes along with low rates of pericardial effusions in HIV-infected outpatients. Our findings are in contrast to the results of publications, performed before the common use of antiretroviral therapy.

  8. Numerical Simulation and Experimental Investigation of 3-D Separated Flow Field around a Blunt Body

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    @@Motivated by re-designing a fuselage in engineering application, the numerical and experimental investigation of the separated flow field around a special blunt body is described in this thesis. The aerodynamic response of the blunt body is successively studied. The thesis consists of four parts: the numerical simulation of the flow field around a two-dimensional blunt body; the numerical simulation of the flow field around a three-dimensional blunt body; the flow

  9. Primary pericardial extragastrointestinal stromal tumor: A case report and literature review

    Science.gov (United States)

    ARPACI, TANER; TOKAT, FATMA; ARPACI, RABIA BOZDOGAN; AKBAS, TUGANA; UGURLUER, GAMZE; YAVUZ, SINAN

    2015-01-01

    Gastrointestinal stromal tumors (GISTs) are the most prevalent mesenchymal tumors of the gastrointestinal tract. GISTs are considered to originate from the interstitial cells of Cajal, the pacemakers of the peristaltic activity of the gastrointestinal tract. More than 95% of GISTs express KIT protein and discovered on GIST-1. GISTs may also be encountered in locations outside the gastrointestinal tract, in which case they are referred to as extra-GISTs (EGISTs) and often behave more aggressively. This is the case report of a primary pericardial EGIST in a 53-year-old male patient, confirmed by immunohistochemistry. To the best of our knowledge, this is the third case of EGIST diagnosed above the diaphragm, without being associated with the esophageal wall. Two cases of primary EGIST arising from the pleura were reported previously. In addition, this is the first reported case of an EGIST originating from the pericardium. PMID:26137136

  10. Spectrum of physiological and pathological cardiac and pericardial uptake of FDG in oncology PET-CT

    International Nuclear Information System (INIS)

    Cardiac uptake of 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) is frequently observed on FDG positron-emission tomography combined with computed tomography (PET-CT) performed for diagnosis, staging, and assessment of therapeutic response of lymphoma and solid cancers, despite careful patient preparation to limit myocardial glucose substrate utilisation. We illustrate the varied physiological patterns of cardiac FDG uptake, and show a spectrum of pathological conditions causing FDG uptake within myocardial and pericardial structures, due to clinically important benign and malignant diseases. Recognition and awareness of these various causes of FDG uptake in the heart, along with the appropriate use of correlative contrast-enhanced CT and magnetic resonance imaging (MRI) will facilitate correct interpretation.

  11. Ergotamine-induced pleural and pericardial effusion successfully treated with colchicine.

    Science.gov (United States)

    Helsen, V; Decoutere, L; Spriet, I; Fagard, K; Boonen, S; Tournoy, J

    2013-01-01

    A 83-year-old woman was admitted to hospital with chest pain, fever, dry cough and palpitations. Chest X-ray revealed a pleural effusion, assumed to be caused by cardiac failure and respiratory infection. Despite treatment with antibiotics and diuretics, the pleural effusion increased on chest X-ray and there were signs of pleural and pericardial effusion on computed tomography (CT) scan. Treatment with non-steroidal anti-inflammatory drugs (NSAIDs) was not successful. Meanwhile patients' long-term use of ergotamine for migraine was revealed, which is associated with pleuropulmonary and cardiac fibrotic reactions. Tentative treatment with colchicine was successful, with complete resolution of pleural fluid, fever, cough and inflammatory parameters. This case highlights the importance of establishing an ergot alkaloid use registry in unexplained pleuropericardial effusions and supports the use of colchicine as a potential therapeutic approach. PMID:23967719

  12. Prevalence of 'high-riding' superior pericardial recesses on thin-section 16-MDCT scans

    International Nuclear Information System (INIS)

    Objective: The aim of this study was to evaluate the prevalence of 'high-riding' superior pericardial recess (HRSPR) on thin-section (1 mm) 16-multidetector computed tomography (MDCT) scans. Materials and methods: Three hundred and fourteen consecutive chest CT scans obtained with a thin-section 16 MDCT were retrospectively evaluated. The prevalence and characteristic of HRSPR were analyzed. Results: HRSPR was depicted in 21 patients (11 men and 10 women) (6.6%) who ranged in age from 28 to 72 years (mean age, 57 years). The extended recesses were rounded/oval shaped in five patients and triangular, spindle, half moon or irregular shaped in the other 16 patients. Conclusion: Our data suggest as HRSPRs are more frequently and better depicted on thinsection MDCT scans, and this improves the capability to distinguish this superior extension of the superior aortic recess from abnormal findings such as lymphadenopathy, cystic lesions, and aortic dissection

  13. An Animal Model of Emotional Blunting in Schizophrenia

    NARCIS (Netherlands)

    Pietersen, Charmaine Y.; Bosker, Fokko J.; Doorduin, Janine; Jongsma, Minke E.; Postema, Folkert; Haas, Joseph V.; Johnson, Michael P.; Koch, Tineke; Vladusich, Tony; den Boer, Johan A.

    2007-01-01

    Schizophrenia is often associated with emotional blunting-the diminished ability to respond to emotionally salient stimuli-particularly those stimuli representative of negative emotional states, such as fear. This disturbance may stem from dysfunction of the amygdala, a brain region involved in fear

  14. Diagnostic Accuracy of Ultrasonography in Blunt Abdominal Trauma

    Directory of Open Access Journals (Sweden)

    A. Mohammadi

    2008-10-01

    Full Text Available Background/Objective: Patients in unstable clinical conditions with blunt abdominal trauma require rapid evaluation of the abdominal organ injury to assess the need for laparatomy. This prospective study was conducted to determine the use of emergency sonography for evaluating patients with blunt abdominal trauma and to compare the accuracy of sonography with the results of diagnostic peritoneal lavage (DPL, exploratory laparatomy and CT"nscan."nPatients and Methods: Emergency sonography was performed prior to any of the diagnostic methods, peritoneal lavage, exploratory laparatomy and CT, on 204 patients with blunt abdominal trauma. Sonography was performed with the "focused abdominal sonography for trauma" (FAST technique and six areas of the abdomen were examined to detect free peritoneal fluid."nResults: Sonography showed a sensitivity of 95.4%, specificity of 78.4% and an overall accuracy of 89% in the diagnosis of free peritoneal fluid. The positive and negative predictive values of sonography were 89.2% and 90.6%, respectively."nConclusion: Sonography is a reliable and accurate method for the emergency evaluation of blunt abdominal trauma.

  15. Peritoneal lavage and other diagnostic procedures in blunt abdominal trauma

    International Nuclear Information System (INIS)

    Diagnostic procedures such as peritoneal lavage, computed tomography, emergency angiography, nuclear scintigraphy, and contrast studies of the gastrointestinal and urinary tracts can assist in the identification, quantification, and localization of injury after blunt abdominal trauma. Use of these procedures should be determined by careful clinically assessment as part of an aggressive approach to the diagnosis of the injured patient. 22 references

  16. The clinical picture of duodenal rupture after blunt abdominal trauma

    International Nuclear Information System (INIS)

    The case of a 30 years old woman who suffered a pneumoretroperitoneum due to a blunt abdominal trauma is reported. The characteristic roentgen signs showing the source of the retroperitoneal air trappings are discussed. The exact analysis of simple abdominal plain films allows early references to an often life-threatening disease without expensive additional examinations. (orig.)

  17. Homicide by blunt force in 2 Scandinavian capitals

    DEFF Research Database (Denmark)

    Rogde, Sidsel; Hougen, Hans P; Poulsen, Klaus

    2003-01-01

    In the Oslo and Copenhagen areas, 77 instances of blunt force homicides were committed from 1985-1994, accounting for 18% of all homicides in that 10-year period. Fifty-four (70%) of the victims were male, often killed by an acquaintance during a fight. Almost 70% of the female victims were kille...

  18. BULLDOZER BLANDER BLUNTING AND ITS INFLUENCE ON MACHINE PRODUCTIVITY

    OpenAIRE

    Demishkan, V.

    2007-01-01

    In the article the interaction of blunting surface with soil has been considered, the influence of cutting depth change on the way of cutting has been determined and the reduction of productivity with the growth of wear surface size has been determined.

  19. Traumatic chylous knee effusion.

    OpenAIRE

    Reginato, A J; Feldman, E; Rabinowitz, J L

    1985-01-01

    A 47-year-old patient presented with a chylous knee effusion and traumatic infected skin lacerations. The diagnosis of septic arthritis was considered because of purulent looking joint fluid, spuriously high synovial fluid white cell count, and signs of acute knee synovitis. Synovial fluid lipid analysis showed increased total lipids due to high concentration of neutral lipids, mainly triglycerides, and repeated knee radiographs showed a small fracture of the tibial spine. Joint trauma with s...

  20. Endovascular Repair of Traumatic Rupture of the Thoracic Aorta: Single-Center Experience

    International Nuclear Information System (INIS)

    Purpose. Traumatic rupture of the thoracic aorta secondary to blunt chest trauma is a life-threatening emergency and a common cause of death, usually following violent collisions. The objective of this retrospective report was to evaluate the efficacy of endovascular treatment of thoracic aortic disruptions with a single commercially available stent-graft. Methods. Nine men (mean age 29.5 years) were admitted to our institution between January 2003 and January 2006 due to blunt aortic trauma following violent motor vehicle collisions. Plain chest radiography, spiral computed tomography, aortography, and transesophageal echocardiography were used for diagnostic purposes in all cases. All patients were diagnosed with contained extramural thoracic aortic hematomas, secondary to aortic disruption. One patient was also diagnosed with a traumatic thoracic aortic dissection, secondary to blunt trauma. All subjects were poor surgical candidates, due to major injuries such as multiple bone fractures, abdominal hematomas, and pulmonary contusions. All repairs were performed using the EndoFit (LeMaitre Vascular) stent-graft. Results. Complete exclusion of the traumatic aortic disruption and pseudoaneurysm was achieved and verified at intraoperative arteriography and on CT scans, within 10 days of the repair in all patients. In 1 case the deployment of a second cuff was necessary due to a secondary endoleak. In 2 cases the left subclavian artery was occluded to achieve adequate graft fixation. No procedure-related deaths have occurred and no cardiac or peripheral vascular complications were observed within the 12 months (range 8-16 months) follow-up. Conclusions. This is the first time the EndoFit graft has been utilized in the treatment of thoracic aortic disruptions secondary to chest trauma. The repair of such pathologies is technically feasible and early follow-up results are promising

  1. Delayed traumatic diaphragmatic hernia

    Science.gov (United States)

    Lu, Jing; Wang, Bo; Che, Xiangming; Li, Xuqi; Qiu, Guanglin; He, Shicai; Fan, Lin

    2016-01-01

    Abstract Background: Traumatic diaphragmatic hernias (TDHs) are sometimes difficult to identify at an early stage and can consequently result in diagnostic delays with life-threatening outcomes. It is the aim of this case study to highlight the difficulties encountered with the earlier detection of traumatic diaphragmatic hernias. Methods: Clinical data of patients who received treatment for delayed traumatic diaphragmatic hernias in registers of the First Affiliated Hospital of Xi’an Jiaotong University from 1998 to 2014 were analyzed retrospectively. Results: Six patients were included in this study. Left hemidiaphragm was affected in all of them. Most of the patients had a history of traffic accident and 1 a stab-penetrating injury. The interval from injury to developing symptoms ranged from 2 to 11 years (median 5 years). The hernial contents included the stomach, omentum, small intestine, and colon. Diaphragmatic injury was missed in all of them during the initial managements. All patients received operations once the diagnosis of delayed TDH was confirmed, and no postoperative mortality was detected. Conclusions: Delayed TDHs are not common, but can lead to serious consequences once occurred. Early detection of diaphragmatic injuries is crucial. Surgeons should maintain a high suspicion for injuries of the diaphragm in cases with abdominal or lower chest traumas, especially in the initial surgical explorations. We emphasize the need for radiographical follow-up to detect diaphragmatic injuries at an earlier stage. PMID:27512848

  2. Adipokine Imbalance in the Pericardial Cavity of Cardiac and Vascular Disease Patients.

    Directory of Open Access Journals (Sweden)

    Atlanta G I M Elie

    Full Text Available Obesity and especially hypertrophy of epicardial adipose tissue accelerate coronary atherogenesis. We aimed at comparing levels of inflammatory and atherogenic hormones from adipose tissue in the pericardial fluid and circulation of cardiovascular disease patients.Venous plasma (P and pericardial fluid (PF were obtained from elective cardiothoracic surgery patients (n = 37. Concentrations of leptin, adipocyte fatty acid-binding protein (A-FABP and adiponectin (APN were determined by enzyme-linked immunosorbent assays (ELISA. The median concentration of leptin in PF (4.3 (interquartile range: 2.8-9.1 μg/L was comparable to that in P (5.9 (2.2-11 μg/L and these were significantly correlated to most of the same patient characteristics. The concentration of A-FABP was markedly higher (73 (28-124 versus 8.4 (5.2-14 μg/L and that of APN was markedly lower (2.8 (1.7-4.2 versus 13 (7.2-19 mg/L in PF compared to P. APN in PF was unlike in P not significantly related to age, body mass index, plasma triglycerides or coronary artery disease. PF levels of APN, but not A-FABP, were related to the size of paracardial adipocytes. PF levels of APN and A-FABP were not related to the immunoreactivity of paracardial adipocytes for these proteins.In cardiac and vascular disease patients, PF is enriched in A-FABP and poor in APN. This adipokine microenvironment is more likely determined by the heart than by the circulation or paracardial adipose tissue.

  3. Neoinnervation and neovascularization of acellular pericardial-derived scaffolds in myocardial infarcts.

    Science.gov (United States)

    Gálvez-Montón, Carolina; Fernandez-Figueras, M Teresa; Martí, Mercè; Soler-Botija, Carolina; Roura, Santiago; Perea-Gil, Isaac; Prat-Vidal, Cristina; Llucià-Valldeperas, Aida; Raya, Ángel; Bayes-Genis, Antoni

    2015-01-01

    Engineered bioimplants for cardiac repair require functional vascularization and innervation for proper integration with the surrounding myocardium. The aim of this work was to study nerve sprouting and neovascularization in an acellular pericardial-derived scaffold used as a myocardial bioimplant. To this end, 17 swine were submitted to a myocardial infarction followed by implantation of a decellularized human pericardial-derived scaffold. After 30 days, animals were sacrificed and hearts were analyzed with hematoxylin/eosin and Masson's and Gallego's modified trichrome staining. Immunohistochemistry was carried out to detect nerve fibers within the cardiac bioimplant by using βIII tubulin and S100 labeling. Isolectin B4, smooth muscle actin, CD31, von Willebrand factor, cardiac troponin I, and elastin antibodies were used to study scaffold vascularization. Transmission electron microscopy was performed to confirm the presence of vascular and nervous ultrastructures. Left ventricular ejection fraction (LVEF), cardiac output (CO), stroke volume, end-diastolic volume, end-systolic volume, end-diastolic wall mass, and infarct size were assessed by using magnetic resonance imaging (MRI). Newly formed nerve fibers composed of several amyelinated axons as the afferent nerve endings of the heart were identified by immunohistochemistry. Additionally, neovessel formation occurred spontaneously as small and large isolectin B4-positive blood vessels within the scaffold. In summary, this study demonstrates for the first time the neoformation of vessels and nerves in cell-free cardiac scaffolds applied over infarcted tissue. Moreover, MRI analysis showed a significant improvement in LVEF (P = 0.03) and CO (P = 0.01) and a 43 % decrease in infarct size (P = 0.007). PMID:26205795

  4. Analysis of the association between periportal low attenuation, as seen on CT, after blunt abdominal trauma, and elevated central venous pressure

    International Nuclear Information System (INIS)

    To assess the causes of periportal low attenuation, as seen on CT, in patients with blunt abdominal trauma. From among 812 patients who underwent abdominal CT after blunt abdominal trauma, we retrospectively analysed the findings in 124 with evidence of periportal low attenuation. Among these, hepatic injury was noted in only 87. The presence or absence, and extent of hepatic injury, and of periportal low attenuation, as seen on CT, were carefully evaluated. In each case, the ratio of the transverse diameter of the inferior vena cava(IVC) to the aorta at the level of the right adrenal gland provided an indirect measurement of central venous pressure ; for control purposes, the ratio was also obtained in 21 non-traumatic patients with no abnormal abdominal CT findings. Of the 87 patients with hepatic injury, 46 showed no periportal low attenuation, and average value of the ratio between the IVC and aorta was 1.16±0.12, while the remaining 41 patients showed periportal low attenuation with a ratio of 1.51±0.21(p<0.05). In the 37 patients with periportal low attenuation but no evidence of concomitant hepatic injury, the average ratio was 1.52±0.25, while in 21 non-traumatic patients it was 1.15±0.16. For resuscitation, all patients had received 0.5-5.0 litre of IV fluid therapy before CT, and at the time of CT, were normotensive. Rapidly elevated central venous pressure following massive IV infusion therapy in patients with blunt abdominal trauma can be one of the causes of periportal low attenuation, as seen on CT

  5. Forensic expertise of thoracic aorta, heart and pericardial injuries in car-occupant fatalities

    OpenAIRE

    Nikolić Slobodan

    2009-01-01

    Introduction. Forensic expertise has not specified with certainty any specific injury among fatally injured frontal car-occupants in frontal car collisions. Objective. To establish if blunt injuries of thoracic aorta, heart, and pericardium could be used as predictors where the fatally injured car-occupant was at the moment of car-collision. Methods. A retrospective autopsy study was performed. The subjects were fatally injured car-drivers, front-seat and rearseat passengers in head-on car co...

  6. Post-traumatic stress disorder

    Science.gov (United States)

    ... Post-traumatic stress disorder References American Psychiatric Association. Diagnostic and statistical manual of mental disorders . 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. ...

  7. Blunt Chest Trauma in Mice after Cigarette Smoke-Exposure: Effects of Mechanical Ventilation with 100% O2.

    Directory of Open Access Journals (Sweden)

    Katja Wagner

    Full Text Available Cigarette smoking (CS aggravates post-traumatic acute lung injury and increases ventilator-induced lung injury due to more severe tissue inflammation and apoptosis. Hyper-inflammation after chest trauma is due to the physical damage, the drop in alveolar PO2, and the consecutive hypoxemia and tissue hypoxia. Therefore, we tested the hypotheses that 1 CS exposure prior to blunt chest trauma causes more severe post-traumatic inflammation and thereby aggravates lung injury, and that 2 hyperoxia may attenuate this effect. Immediately after blast wave-induced blunt chest trauma, mice (n=32 with or without 3-4 weeks of CS exposure underwent 4 hours of pressure-controlled, thoraco-pulmonary compliance-titrated, lung-protective mechanical ventilation with air or 100% O2. Hemodynamics, lung mechanics, gas exchange, and acid-base status were measured together with blood and tissue cytokine and chemokine concentrations, heme oxygenase-1 (HO-1, activated caspase-3, and hypoxia-inducible factor 1-α (HIF-1α expression, nuclear factor-κB (NF-κB activation, nitrotyrosine formation, purinergic receptor 2X4 (P2XR4 and 2X7 (P2XR7 expression, and histological scoring. CS exposure prior to chest trauma lead to higher pulmonary compliance and lower PaO2 and Horovitz-index, associated with increased tissue IL-18 and blood MCP-1 concentrations, a 2-4-fold higher inflammatory cell infiltration, and more pronounced alveolar membrane thickening. This effect coincided with increased activated caspase-3, nitrotyrosine, P2XR4, and P2XR7 expression, NF-κB activation, and reduced HIF-1α expression. Hyperoxia did not further affect lung mechanics, gas exchange, pulmonary and systemic cytokine and chemokine concentrations, or histological scoring, except for some patchy alveolar edema in CS exposed mice. However, hyperoxia attenuated tissue HIF-1α, nitrotyrosine, P2XR7, and P2XR4 expression, while it increased HO-1 formation in CS exposed mice. Overall, CS exposure

  8. Chronic Traumatic Encephalopathy: The Neuropathological Legacy of Traumatic Brain Injury.

    Science.gov (United States)

    Hay, Jennifer; Johnson, Victoria E; Smith, Douglas H; Stewart, William

    2016-05-23

    Almost a century ago, the first clinical account of the punch-drunk syndrome emerged, describing chronic neurological and neuropsychiatric sequelae occurring in former boxers. Thereafter, throughout the twentieth century, further reports added to our understanding of the neuropathological consequences of a career in boxing, leading to descriptions of a distinct neurodegenerative pathology, termed dementia pugilistica. During the past decade, growing recognition of this pathology in autopsy studies of nonboxers who were exposed to repetitive, mild traumatic brain injury, or to a single, moderate or severe traumatic brain injury, has led to an awareness that it is exposure to traumatic brain injury that carries with it a risk of this neurodegenerative disease, not the sport or the circumstance in which the injury is sustained. Furthermore, the neuropathology of the neurodegeneration that occurs after traumatic brain injury, now termed chronic traumatic encephalopathy, is acknowledged as being a complex, mixed, but distinctive pathology, the detail of which is reviewed in this article. PMID:26772317

  9. Unusual Thymic Hyperplasia Mimicking Lipomatous Tumor in an Eight-Year-Old Boy with Concomitant Pericardial Lipomatosis and Right Facial Hemihypertrophy

    International Nuclear Information System (INIS)

    We report a case of thymic hyperplasia accompanied by pericardial lipomatosis and right facial hemihypertrophy in an 8-year-old boy. On imaging studies, the hyperplastic thymus had prominent curvilinear and nodular fatty areas simulating a fat-containing anterior mediastinal mass, which is an unusual finding in children. To our knowledge, this is the first report on a child with a combination of thymic hyperplasia, pericardial lipomatosis, and right facial hemihypertrophy. The radiologic findings are presented with a brief discussion.

  10. A rare case of isolate pericardial effusion detected by SPECT/CT on a post-therapeutic radioiodine whole-body scan

    Energy Technology Data Exchange (ETDEWEB)

    Tan, Teik Hin [Dept. of Nuclear Medicine, National Cancer Institute, Putrajaya (Malaysia); Hassan, Siti Zarina Amir [Dept. of Nuclear Medicine, Kuala Lumpur Hospital, Kuala Lumpur (Malaysia)

    2015-09-15

    We reported a rare finding of isolated pericardial uptake detected by SPECT/CT on posttherapeutic radioiodine whole body scan. This case highlights the usefulness of hybrid SPECT/CT, with subsequent correlation with biochemical results, in ruling out metastatic pericardial effusion in the postsurgical radioiodine remnant ablation setting. The effusion was resolved after reinstituted thyroid replacement therapy. Recombinant thyrotropin is recommended to avoid such rare but life-threatening complication.

  11. A rare case of isolate pericardial effusion detected by SPECT/CT on a post-therapeutic radioiodine whole-body scan

    International Nuclear Information System (INIS)

    We reported a rare finding of isolated pericardial uptake detected by SPECT/CT on posttherapeutic radioiodine whole body scan. This case highlights the usefulness of hybrid SPECT/CT, with subsequent correlation with biochemical results, in ruling out metastatic pericardial effusion in the postsurgical radioiodine remnant ablation setting. The effusion was resolved after reinstituted thyroid replacement therapy. Recombinant thyrotropin is recommended to avoid such rare but life-threatening complication

  12. Haemostasis with fibrin glue injection into the pericardial space for right ventricular perforation caused by an iatrogenic procedural complication.

    Science.gov (United States)

    Arai, Hirofumi; Miyamoto, Takamichi; Hara, Nobuhiro; Obayashi, Tohru

    2016-01-01

    An 89-year-old woman with severe aortic valve stenosis and bradycardia presented with circulatory shock due to cardiac tamponade. We performed pericardiocentesis, and then diagnosed right ventricular perforation by echocardiography with microcavitation contrast medium just before inserting a drainage tube. We then inserted the drainage tube in the appropriate position and withdrew blood-filled fluid. The patient was haemodynamically stabilised, but haemorrhage from the perforation site continued for a few days. We injected fibrin glue into the pericardial space through the drainage tube and achieved haemostasis. Thus, we avoided surgery to close the perforation in this high-risk patient. There was no recurrence of haemorrhage. She subsequently had elective aortic valve replacement at another hospital. No adhesions in the pericardial space were seen during surgery. PMID:27190133

  13. Analysis of 133 patients with severe blunt liver injury

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To investigate the treatment and causes of death aboutsevere blunt liver injury.Methods: The data of 133 patients with severe blunt liver injury (Grade Ⅲ to Grade Ⅴ) were analyzed retrospectively. All the patients except 2 underwent operations. Different types of surgical procedures were adopted according to the severity of liver injury.Results: Operations were the major method to treat hepatic injury. The total mortality rate was 21.0% in this study. The mortality rates of Grade Ⅲ, Grade Ⅳ and Grade Ⅴ of liver injuries were 11.3%, 24.4% and 69.2%, respectively.Conclusions: Packing treatment plays an important role in the treatment of hepatic injury. The mortality rate is related closely to the severity of hepatic injury, multiple trauma, shock and disturbance of blood coagulation.

  14. CT of blunt pancreatic trauma-A pictorial essay

    Energy Technology Data Exchange (ETDEWEB)

    Venkatesh, Sudhakar Kundapur [Diagnostic Radiology, National University Hospital, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119074 (Singapore)], E-mail: dnrskv@nus.edu.sg; Wan, John Mun Chin [Diagnostic Radiology, National University Hospital, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119074 (Singapore)

    2008-08-15

    Blunt trauma to pancreas is uncommon and clinical features are often non-specific and unreliable leading to possible delays in diagnosis and therefore increased morbidity. CT has been established as the imaging modality of choice for the diagnosis of abdominal solid-organ injury in the blunt trauma patient. The introduction of multidetector-row CT allows for high resolution scans and multiplanar reformations that improve diagnosis. Detection of pancreatic injuries on CT requires knowledge of the subtle changes produced by pancreatic injury. The CT appearance of pancreatic injury ranges from a normal initial appearance of the pancreas to active pancreatic bleeding. Knowledge of CT signs of pancreatic trauma and a high index of suspicion is required in diagnosing pancreatic injury.

  15. CT findings in children with blunt trauma in the spleen

    International Nuclear Information System (INIS)

    We evaluated CT findings in 19 children with blunt injuries in the spleen. CT demonstrated laceration of the spleen in 7 children, rupture of the spleen in 7, and splenic hematoma in 5. Leakage of the contrast medium was observed in 3 children, of whom 1 was treated by arterial embolization. Laparotomy was performed in 3 children (15.8%) other than the 3 showing contrast medium leakage; hemostasis by compression was performed in 1 with laceration, and splenectomy in 2 with rupture. Late splenic rupture or abscess did not occur in any child. One child (5.3%) died of complicating injuries. Many of children with blunt splenic injuries can be successfully treated with conservative treatment, and CT scanning is useful for evaluating the degree of splenic injuries and complicating injuries. (author)

  16. Total venous inflow occlusion and pericardial auto-graft reconstruction for right atrial hemangiosarcoma resection in a dog.

    Science.gov (United States)

    Verbeke, Fei; Binst, Dominique; Stegen, Ludo; Waelbers, Tim; de Rooster, Hilde; Van Goethem, Bart

    2012-10-01

    A sizeable right atrial hemangiosarcoma in a 6-year-old Bordeaux dog, World Health Organization (WHO) stage 2, was excised using total venous inflow occlusion. The defect was restored with a non-vascularized pericardial auto-graft. The dog had a disease-free interval of 7 mo. The dog was euthanized 9 months later, at which time there were distant metastases but no indication of local recurrence. PMID:23543933

  17. Total venous inflow occlusion and pericardial auto-graft reconstruction for right atrial hemangiosarcoma resection in a dog

    OpenAIRE

    Verbeke, Fei; Binst, Dominique; Stegen, Ludo; Waelbers, Tim; De Rooster, Hilde; Van Goethem, Bart

    2012-01-01

    A sizeable right atrial hemangiosarcoma in a 6-year-old Bordeaux dog, World Health Organization (WHO) stage 2, was excised using total venous inflow occlusion. The defect was restored with a non-vascularized pericardial auto-graft. The dog had a disease-free interval of 7 mo. The dog was euthanized 9 months later, at which time there were distant metastases but no indication of local recurrence.

  18. Fat contamination of pericardial suction blood in cardiac surgery : clinical and experimental studies in perspectives of transfusion logistics

    OpenAIRE

    Appelblad, Micael

    2006-01-01

    Introduction: During cardiac surgery aided by cardiopulmonary bypass (CPB) the autotransfusion of pericardial suction blood (PSB) is regarded mandatory to limit allogeneic blood exposure. PSB is however proposed as a source of lipid microemboli and to contribute to brain damage. This thesis addresses the logistics of allogeneic blood transfusion during coronary artery bypass grafting (CABG), the embolic potential of reinfused PSB, and means to reduce PSB fat contamination, investigated both c...

  19. Polymicrobial Purulent Pericarditis Probably caused by a Broncho-Lymph Node-Pericardial Fistula in a Patient with Tuberculous Lymphadenitis

    OpenAIRE

    Lee, Seung(Department of Physics, Korea Advanced Institute of Science and Technology, 335 Gwahak-ro, Yuseong-gu, Daejeon, 305-701, Korea); Lee, Kanglok; Ko, Jun Kwon; Park, Jaekeun; Yu, Mi Yeon; Oh, Chang Kyo; Hong, Seung Pyo; Kim, Yeonjae; Lim, Younghyo; Kim, Hyuck; Pai, Hyunjoo

    2015-01-01

    Purulent pericarditis is a rare condition with a high mortality rate. We report a case of purulent pericarditis subsequently caused by Candida parapsilosis, Peptostreptococcus asaccharolyticus, Streptococcus anginosus, Staphylococcus aureus, Prevotella oralis, and Mycobacterium tuberculosis in a previously healthy 17-year-old boy with mediastinal tuberculous lymphadenitis. The probable route of infection was a bronchomediastinal lymph node-pericardial fistula. The patient improved with antibi...

  20. Analysis of risk factors for rebleeding after splenectomy and pericardial devascularization in treatment of portal hypertension due to liver cirrhosis

    Directory of Open Access Journals (Sweden)

    ZHANG Lei

    2015-03-01

    Full Text Available ObjectiveTo investigate the possible risk factors for rebleeding after splenectomy and pericardial devascularization in the treatment of portal hypertension due to liver cirrhosis, and to provide a certain basis for reducing the incidence of digestive tract re-hemorrhage for these patients. MethodsA retrospective analysis was performed on 238 cirrhotic patients with portal hypertension who underwent splenectomy and pericardial devascularization in the First Hospital of Lanzhou University from December 2003 to December 2013. These patients were divided into postoperative rebleeding group (n=32 and non-bleeding group (n=206. Univariate analysis (t test or chi-square test and multivariate logistic regression analysis were performed to investigate the risk factors for rebleeding after splenectomy and pericardial devascularization. ResultsOf the 32 patients with postoperative rebleeding, 17 had esophagogastric variceal bleeding, 11 had bleeding due to portal hypertensive gastropathy, and 4 had stress ulcer bleeding. The univariate analysis showed that there were significant differences between the two groups in the following factors: Child-Pugh classification of liver function, degree of liver cirrhosis evaluated intraoperatively, pathological changes of the gastric mucosa, platelet count, prothrombin time (PT, activated partial thromboplastin time (APTT, and presence of diabetes (all P<0.05. The multivariate logistic regression analysis suggested that the significant independent influential factors for postoperative rebleeding were presence of diabetes, Child-Pugh classification of liver function, degree of liver cirrhosis evaluated intraoperatively, diffuse lesion of the gastric mucosa, PT, and APTT. ConclusionFor cirrhotic patients with portal hypertension, the appropriate methods for managing these risk factors are of great clinical significance for preventing rebleeding after splenectomy and pericardial devascularization.

  1. Renal Pelvis Injury in Case of Blunt Trauma Abdomen

    Directory of Open Access Journals (Sweden)

    Rajendra B. Nerli

    2015-07-01

    Full Text Available Isolated renal pelvis/upper ureteric injuries are uncommon in a case of blunt abdominal trauma. These injuries are associated with fractures of transverse process of the adjoining vertebrae. We report a case of such a case in a 35 year old male involved in road traffic accident. He underwent exploration and repair of the right UPJ/Upper ureteric injury. This case presented with injury to the transverse processes on the left side, which is unusual.

  2. Are routine pelvic radiographs in major pediatric blunt trauma necessary?

    International Nuclear Information System (INIS)

    Screening pelvic radiographs to rule out pelvic fractures are routinely used for the initial evaluation of pediatric blunt trauma. Recently, the utility of routine pelvic radiographs in certain subsets of patients with blunt trauma has been questioned. There is a growing amount of evidence that shows the clinical exam is reliable enough to obviate the need for routine screening pelvic radiographs in children. To identify variables that help predict the presence or absence of pelvic fractures in pediatric blunt trauma. We conducted a retrospective study from January 2005 to January 2010 using the trauma registry at a level 1 pediatric trauma center. We analyzed all level 1 and level 2 trauma victims, evaluating history, exam and mechanism of injury for association with the presence or absence of a pelvic fracture. Of 553 level 1 and 2 trauma patients who presented during the study period, 504 were included in the study. Most of these children, 486/504 (96.4%), showed no evidence of a pelvic fracture while 18/504 (3.6%) had a pelvic fracture. No factors were found to be predictive of a pelvic fracture. However, we developed a pelvic fracture screening tool that accurately rules out the presence of a pelvic fracture P = 0.008, NPV 99, sensitivity 96, 8.98 (1.52-52.8). This screening tool combines eight high-risk clinical findings (pelvic tenderness, laceration, ecchymosis, abrasion, GCS <14, positive urinalysis, abdominal pain/tenderness, femur fracture) and five high-risk mechanisms of injury (unrestrained motor vehicle collision [MVC], MVC with ejection, MVC rollover, auto vs. pedestrian, auto vs. bicycle). Pelvic fractures in pediatric major blunt trauma can reliably be ruled out by using our pelvic trauma screening tool. Although no findings accurately identified the presence of a pelvic fracture, the screening tool accurately identified the absence of a fracture, suggesting that pelvic radiographs are not warranted in this subset of patients. (orig.)

  3. Severe Pulmonary Valve Regurgitation 40 Years After Blunt Chest Trauma.

    Science.gov (United States)

    Fuglsang, Simon; Heiberg, Johan; Hjortdal, Vibeke Elisabeth

    2015-10-01

    Severe pulmonary valve regurgitation caused by a pulmonary valve tear is a rare complication to a blunt chest trauma. In this case report, we present a patient with pulmonary regurgitation originating from a chest trauma 40 years ago. Possible mechanisms are osseous pinch of the pulmonary valve between the anterior chest wall and the vertebral column, and retrograde blowout from severe compression of the lungs. PMID:26434447

  4. Diagnostic Accuracy of Secondary Ultrasound Exam in Blunt Abdominal Trauma

    International Nuclear Information System (INIS)

    In stable patients with blunt abdominal trauma, accurate diagnosis of visceral injuries is crucial. To determine whether repeating ultrasound exam will increase the sensitivity of focused abdominal sonography for trauma (FAST) through revealing additional free intraperitoneal fluid in patients with blunt abdominal trauma. We performed a prospective observational study by performing primary and secondary ultrasound exams in blunt abdominal trauma patients. All ultrasound exams were performed by four radiology residents who had the experience of more than 400 FAST exams. Five routine intraperitoneal spaces as well as the interloop space were examined by ultrasound in order to find free fluid. All patients who expired or were transferred to the operating room before the second exam were excluded from the study. All positive ultrasound results were compared with intra-operative and computed tomography (CT) findings and/or the clinical status of the patients. Primary ultrasound was performed in 372 patients; 61 of them did not undergo secondary ultrasound exam; thus, were excluded from the study.Three hundred eleven patients underwent both primary and secondary ultrasound exams. One hundred and two of all patients were evaluated by contrast enhanced CT scan and 31 underwent laparotomy. The sensitivity of ultrasound exam in detecting intraperitoneal fluid significantly increased from 70.7% for the primary exam to 92.7% for the secondary exam. Examining the interloop space significantly improved the sensitivity of ultrasonography in both primary (from 36.6% to 70.7%) and secondary (from 65.9% to 92.7%) exams. Performing a secondary ultrasound exam in stable blunt abdominal trauma patients and adding interloop space scan to the routine FAST exam significantly increases the sensitivity of ultrasound in detecting intraperitoneal free fluid

  5. Are routine pelvic radiographs in major pediatric blunt trauma necessary?

    Energy Technology Data Exchange (ETDEWEB)

    Lagisetty, Jyothi [Memorial Hermann Medical Center, Emergency Medicine Department, Houston, TX (United States); Slovis, Thomas [Wayne State University School of Medicine, Department of Radiology, Pediatric Imaging, Children' s Hospital of Michigan, Detroit, MI (United States); Thomas, Ronald [Children' s Hospital of Michigan, Wayne State University of Medicine, Department of Pediatrics, Detroit, MI (United States); Knazik, Stephen; Stankovic, Curt [Wayne State University of Medicine, Division of Emergency Medicine, Children' s Hospital of Michigan, Detroit, MI (United States)

    2012-07-15

    Screening pelvic radiographs to rule out pelvic fractures are routinely used for the initial evaluation of pediatric blunt trauma. Recently, the utility of routine pelvic radiographs in certain subsets of patients with blunt trauma has been questioned. There is a growing amount of evidence that shows the clinical exam is reliable enough to obviate the need for routine screening pelvic radiographs in children. To identify variables that help predict the presence or absence of pelvic fractures in pediatric blunt trauma. We conducted a retrospective study from January 2005 to January 2010 using the trauma registry at a level 1 pediatric trauma center. We analyzed all level 1 and level 2 trauma victims, evaluating history, exam and mechanism of injury for association with the presence or absence of a pelvic fracture. Of 553 level 1 and 2 trauma patients who presented during the study period, 504 were included in the study. Most of these children, 486/504 (96.4%), showed no evidence of a pelvic fracture while 18/504 (3.6%) had a pelvic fracture. No factors were found to be predictive of a pelvic fracture. However, we developed a pelvic fracture screening tool that accurately rules out the presence of a pelvic fracture P = 0.008, NPV 99, sensitivity 96, 8.98 (1.52-52.8). This screening tool combines eight high-risk clinical findings (pelvic tenderness, laceration, ecchymosis, abrasion, GCS <14, positive urinalysis, abdominal pain/tenderness, femur fracture) and five high-risk mechanisms of injury (unrestrained motor vehicle collision [MVC], MVC with ejection, MVC rollover, auto vs. pedestrian, auto vs. bicycle). Pelvic fractures in pediatric major blunt trauma can reliably be ruled out by using our pelvic trauma screening tool. Although no findings accurately identified the presence of a pelvic fracture, the screening tool accurately identified the absence of a fracture, suggesting that pelvic radiographs are not warranted in this subset of patients. (orig.)

  6. Diagnostic management of blunt abdominal trauma in children

    International Nuclear Information System (INIS)

    Children with abdominal injuries after blunt trauma can be managed non operatively in most cases. Rapid diagnosis is essential to select those patients who need immediate operation. Diagnostic methods of choice are ultrasonography, already performed in the emergency setting and contrast enhanced CT of the abdomen in hemodynamically stable patients. This work discusses the different diagnostic strategies and their use in the clinical practice. (orig.)

  7. Improvement of airfoil trailing edge bluntness noise model

    OpenAIRE

    Zhu, Wei Jun; Shen, Wen Zhong; Sørensen, Jens Nørkær; Leloudas, Giorgos

    2016-01-01

    In this article, airfoil trailing edge bluntness noise is investigated using both computational aero-acoustic and semi-empirical approach. For engineering purposes, one of the most commonly used prediction tools for trailing edge noise are based on semi-empirical approaches, for example, the Brooks, Pope, and Marcolini airfoil noise prediction model developed by Brooks, Pope, and Marcolini (NASA Reference Publication 1218, 1989). It was found in previous study that the Brooks, Pope, and Marco...

  8. An animal model of emotional blunting in schizophrenia.

    Directory of Open Access Journals (Sweden)

    Charmaine Y Pietersen

    Full Text Available Schizophrenia is often associated with emotional blunting--the diminished ability to respond to emotionally salient stimuli--particularly those stimuli representative of negative emotional states, such as fear. This disturbance may stem from dysfunction of the amygdala, a brain region involved in fear processing. The present article describes a novel animal model of emotional blunting in schizophrenia. This model involves interfering with normal fear processing (classical conditioning in rats by means of acute ketamine administration. We confirm, in a series of experiments comprised of cFos staining, behavioral analysis and neurochemical determinations, that ketamine interferes with the behavioral expression of fear and with normal fear processing in the amygdala and related brain regions. We further show that the atypical antipsychotic drug clozapine, but not the typical antipsychotic haloperidol nor an experimental glutamate receptor 2/3 agonist, inhibits ketamine's effects and retains normal fear processing in the amygdala at a neurochemical level, despite the observation that fear-related behavior is still inhibited due to ketamine administration. Our results suggest that the relative resistance of emotional blunting to drug treatment may be partially due to an inability of conventional therapies to target the multiple anatomical and functional brain systems involved in emotional processing. A conceptual model reconciling our findings in terms of neurochemistry and behavior is postulated and discussed.

  9. Non-operative management of adult blunt splenic injuries

    Institute of Scientific and Technical Information of China (English)

    YANG Jun; GAO Jin-mou; Jean-Claude Baste

    2006-01-01

    Objective: To investigate the indication of nonoperative management of adult blunt splenic injuries.Methods: A retrospective review was performed on all adult patients (age > 15 years ) with blunt splenic injuries admitted to the department of vascular surgery of Pellegrin hospital in France from 1999 to 2003. We managed splenic injuries non-operatively in all appropriate patients without regard to age.Results: During the 4 years, 54 consecutive adult patients with blunt splenic injuries were treated in the hospital. A total of 27 patients with stable hemodynamic status were treated non-operatively at first, of which 2 patients were failed to non-operative treatment. The successful percentage of non-operative management was 92.6 %. In the 54 patients, 7 of 8 patients older than 55 years were treated with non-operative management. Two cases developing postoperatively subphrenic infection were healed by proper treatment. In the series, there was no death.Conclusions: Non-operative management of low-grade splenic injuries can be accomplished with an acceptable low-failure rate. If the clinical and laboratory parameters difficult for surgeons to make decisions, they can depend on Resciniti' s CT (computed tomography)scoring system to select a subset of adults with splenic trauma who are excellent candidates for a trial of nonoperative management. The patients older than 55 years are not absolutely inhibited to receive non-operative management.

  10. Computed tomography and nonoperative treatment for blunt abdominal trauma

    International Nuclear Information System (INIS)

    Studies were undertaken to determine if computed tomography (CT) could reliably assist physical examination in the initial assessment of blunt abdominal trauma, and also to examine how various abdominal injuries were managed with the guidance of CT. A total of 255 patients underwent emergency abdominal CT following blunt abdominal trauma over a period of seven years. One hundred and fifty two patients had abnormal CT scans, including 58 hepatic, 36 renal, 25 splenic and 9 pancreatic injuries as well as 67 patients with intra-abdominal hemorrhage and 21 patients with free abdominal air. A comparative study on the detection of pneumoperitoneum revealed CT to be far superior to plain radiography. One hundred and three patients had normal CT scans, all of whom were managed nonoperatively, except for three false-negative cases and two nontherapeutic cases. The patients with injury to the parenchymal organs were given nonoperative treatment if they had stable vital signs and no evidence of associated injuries demanding immediate surgery and the majority of these patients were managed well nonoperatively. CT was thus found to be a useful adjunct in the management of victims of blunt abdominal trauma, since in a rapid and noninvasive fashion, CT accurately defined the extent of parenchymal organ injury and also disclosed any other abdominal injuries. (author)

  11. CT scanning for diagnosing blunt ureteral and ureteropelvic junction injuries

    Directory of Open Access Journals (Sweden)

    Chu Peter

    2008-02-01

    Full Text Available Abstract Background Blunt ureteral and ureteropelvic (UPJ injuries are extremely rare and very difficult to diagnose. Many of these injuries are missed by the initial trauma evaluation. Methods Trauma registry data was used to identify all blunt trauma patients with ureteral or UPJ injuries, from 1 April 2001 to 30 November 2006. Demographics, injury information and outcomes were determined. Chart review was then performed to record initial clinical and all CT findings. Results Eight patients had ureteral or UPJ injuries. Subtle findings such as perinephric stranding and hematomas, and low density retroperitoneal fluid were evident on all initial scans, and prompted delayed excretory scans in 7/8 cases. As a result, ureteral and UPJ injuries were diagnosed immediately for these seven patients. These findings were initially missed in the eighth patient because significant associated visceral findings mandated emergency laparotomy. All ureteral and UPJ injuries have completely healed except for the case with the delay in diagnosis. Conclusion Most blunt ureteral and UPJ injuries can be identified if delayed excretory CT scans are performed based on initial CT findings of perinephric stranding and hematomas, or the finding of low density retroperitoneal fluid.

  12. Efficacy of Radiofrequency Hyperthermia Combined with Chemotherapy 
in Treatment of Malignant Pericardial Effusion Caused by Lung Cancer

    Directory of Open Access Journals (Sweden)

    Pengfei LUO

    2011-07-01

    Full Text Available Background and objective Malignant pericardial effusion is one of the serious complications of lung cancer and lack effective treatment methods. The aim of this study is to evaluate the efficacy and safety of radiofrequency hyperthermia combined with chemotherapy for patients with malignant pericardial effusion caused by lung cancer. Methods Fifty-five patients with malignant pericardial effusion caused by lung cancer were divided into hyperthermia combined with chemotherapy group (combined therapy group and chemotherapy group. The combined therapy group was treated with radiofrequency hyperthermia after the pericardiocentesis and intracavitary injection (cisplatin 20 mg and dexamethasone 5 mg, when patients’ general state of health improved, systemic chemotherapy was performed. The chemotherapy group was treated only with intracavitary injection and systemic chemotherapy. Intracavitary chemotherapy was performed for 1-6 times (average 3 times. Hyperthermia was performed twice per week with an average of 6 times following intracavitary and systemic chemotherapy. The temperature of intracavitary was 40.5 oC-41.5 oC for 60 min during the hyperthermia periods. Systemic chemotherapy consists of cisplatin (75 mg/m2 and vinorelbine (50 mg/m2. Results The complete remission rate (CR of malignant pericardial effusion was 54.3% and the response rate (RR was 91.4% in the combined therapy group, while the rates of CR and RR of chemotherapy group were 25.0% and 70.0%, and the differences of CR and RR between the two groups were significant (P<0.05. After treatment, the quality of life improved significantly in both groups, but the combined therapy group had a higher KPS score than in the chemotherapy group (P<0.05. The adverse events associated with the chemotherapy included gastrointestinal toxicity and myelosup-pression, and there were no significant differences between the two groups. The main side effects associated with radiofrequency hyperthermia

  13. SING CRYOPRESERVED HOMOGRAFT PERICARDIAL PATCH IN STAGED COMPLETE REPAIR FOR TETRALOGY OF FALLOT

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To compare the difference of effect while using homograt pericardium patch and Gore-tex patch in staged complete repair for Tetralogy of Fallot (TOF) to enlarge the right ventricular ouflow tract (RVOT). Methods Twenty-eight patients with TOF underwent the staged complete repair. Gore-tex patches were used to enlarge the RVOT of 13 patients, and cryopreserved homograft pericardium patches were used to enlarge the RVOT of 15 patients. The patients were followed up with 2-dimensional echocardiography and chest x-ray.Results One operative death in Gore-tex patch group, the mortality was 7. 7%; 1 early postoperative death in cryopreserved homograft pericardium patch group, the mortality was 6. 7%. Between 2 groups, hemostasia time in operation room with significant difference ( P < 0. 01 ) , pericardial cavity drainage volume with difference ( P < 0. 05). Gore-tex patch group was followed up 2 to 4.5 years, homograft pericardium patch group was followed up 0. 8 to 2. 1 years. Echocardiography showed that there was significant difference of the residual obstruction at RVOT level ( P < 0. 01 ). No calcification shadow was discovered on the chest x-ray of both groups. Conclusion Homograft pericardium is tissue with high density and intensity, its elasticity and compliance are good. Using homograft pericardium patch maybe helpful to decrease the residual obstruction of RVOT after operation. It can be adapted as a repairing material in cardiac surgery.

  14. Noninferiority of Shanghai Cingular biotech’s bovine pericardial valve preclinical study in juvenile ovine model

    Science.gov (United States)

    Chen, Jin-Miao; Ding, Yu; Lu, Shu-Yang; Pan, Sun; Abudupataer, Mieradilijiang

    2016-01-01

    Background This study introduces a newly Chinese domestic-designed/manufactured bovine pericardial valve, the SCBC valve (Shanghai Cingular Biotech Corporation, Shanghai, China), and evaluates its hemodynamic performance and calcification potential compared with the Carpentier-Edwards (CE) PerimountTM valve (Edwards Lifesciences, Irvine, CA, USA) in juvenile sheep for preclinical study. Methods Five SCBC valves in study group and three CE PerimountTM valves (6900P with TFX) in control group were implanted in the mitral position of juvenile sheep and followed up for five months. Transthoracic echocardiography (TTE) for hemodynamic measurement was performed ten days, three months and five months postoperatively. Valve calcification was assessed by X-ray after euthanasia. Other collected data included macroscopic examination, blood analysis, microorganism culture and histological assessment. Results All sheep in two groups lived to sacrifice without evidence of valvular dysfunction. The SCBC valve had similar hemodynamic performance and susceptibility of calcification compared with the CE PerimountTM valve in juvenile ovine model. In all other parameters, the SCBC valve also exhibited no significant difference compared with the CE PerimountTM valve. Conclusions Our study demonstrated that the SCBC valve can exhibit similar mid-term satisfactory safety and efficacy compared with the CE PerimountTM valve in the mitral position of juvenile sheep model. PMID:27293835

  15. Effect of colchicine in prevention of pericardial effusion and atrial fibrillation: a meta-analysis.

    Science.gov (United States)

    Wang, Ming-Xuan; Deng, Xiao-Long; Mu, Bing-Yao; Cheng, Yong-Jing; Chen, Ying-Juan; Wang, Qian; Huang, Jia; Zhou, Rong-Wei; Huang, Ci-Bo

    2016-09-01

    Randomized, controlled trials (RCTs) have assessed the effect of colchicine therapy in prevention of pericardial effusion (PE) and atrial fibrillation (AF). However, the effects are still inconclusive. PubMed, Cochrane Library, Google Scholar, and EMBASE database were searched. Primary outcome was the risk of PE and AF. Ten RCTs with 1981 patients and a mean follow-up of 12.6 months were included. Colchicine therapy was not associated with a significantly lower risk of post-operative PE (RR, 0.89; 95 % CI 0.70-1.13; p = 0.33, I (2) = 72.8 %) and AF (RR, 0.77; 95 % CI 0.52-1.13; p = 0.18, I (2) = 47.3 %). However, rates of pericarditis recurrence, symptoms persistence, and pericarditis-related hospitalization were significantly decreased with colchicine treatment. In addition, cardiac tamponade occurrence was similar between groups, and adverse events were significantly higher in the colchicine group. Colchicine may not significantly decrease the post-operative risk of PE and AF. However, only limited studies about patients undergoing cardiac surgery provide data about PE and AF. PMID:27378573

  16. Contaminating fat in pericardial suction blood: a clinical, technical and scientific challenge.

    Science.gov (United States)

    Engström, Karl Gunnar

    2004-01-01

    Stroke and diffuse brain damage after cardiac surgery are too common. It is important to find means to reduce the incidence in view of future competition to surgery from less invasive procedures. Stroke is fairly well defined in clinical terms and with several identified mechanisms. Diffuse brain damage is less well defined and more complex in nature. One suggested mechanism is from cerebral fat microembolization of retrieved pericardial suction blood (PSB). The present study aimed to describe a simple method to measure fat content of PSB, how experimental artefacts interfere with the results, and how the unstable character of a fat-blood suspension can be used to design a simple fat-separation system. The quantity of small amounts of fat can be amplified by centrifugation to the tapered tip of a standard glass pipette. The coefficient of variation after repeated experiments was 9.5%. PSB after coronary bypass surgery contained 0.22 +/- 0.04% fat of which 15 +/- 3% was bound to the surface of the plastic collecting bag. Experimentation requires standardized routines. Static incubation, blood-fat mixing routines, and transfer steps of blood samples between syringes induce substantial artefacts from spontaneous density separation and surface-adhesion of fat. Soya oil is a common reference substance replacing human fat in technical laboratory science, but is associated with artefacts of its own. These artefacts cause problems during experimentation but the oil is a good resource in the design of a simple fat-separation system. PMID:15161061

  17. Evaluation of postmortem drug concentrations in cerebrospinal fluid compared with blood and pericardial fluid.

    Science.gov (United States)

    Tominaga, Mariko; Michiue, Tomomi; Ishikawa, Takaki; Inamori-Kawamoto, Osamu; Oritani, Shigeki; Maeda, Hitoshi

    2015-09-01

    In forensic toxicology, body fluids are important materials not only as alternatives to blood but also for investigation of postmortem drug redistributions and pharmaco-/toxicokinetic analysis; however, there are limited data on postmortem drug distributions in cerebrospinal fluid (CSF). The present study reviewed toxicological data of autopsy cases (n=103), in which drugs were detected in CSF using gas chromatography/mass spectrometry (GC/MS), to investigate drug concentrations in CSF, compared with blood and pericardial fluid (PCF) concentrations. Oral/injected amphetamines (n=23) showed similar CSF and blood/PCF concentrations with partly lower CSF concentrations (about ×0.5-1.1). CSF concentrations of the venous anesthetic midazolam (n=7) were lower with poor correlations. Oral caffeine (n=15), acetaminophen (n=7), chlorpheniramine (n=6), dihydrocodeine (n=6), and phenobarbital (n=21) showed equivalent to lower CSF concentrations (about ×0.2-1.2), compared with blood and PCF concentrations; however, CSF phenobarbital concentrations were high in a fatal intoxication case. CSF concentrations of phenothiazine derivatives (n=29) were markedly lower (about ×0.1) than blood/PCF concentrations. The distribution of the local anesthetic lidocaine used in critical medical care (n=49) markedly varied by case. These findings suggest that CSF is useful in routine forensic toxicology as an alternative to blood as well as for investigating pharmaco-/toxicokinetics and postmortem redistributions. PMID:26218406

  18. Pericardial synovial sarcoma: challenges in diagnosis and management [v2; ref status: indexed, http://f1000r.es/329

    Directory of Open Access Journals (Sweden)

    Prajakta Phatak

    2014-03-01

    Full Text Available Introduction: Pericardial synovial sarcoma is an extremely rare tumor with poor prognosis. Timely diagnosis and aggressive multimodal management improves patient outcome. We present our experience of diagnosis and management of a young patient with monophasic synovial sarcoma arising from pericardium. Case: A 27-year-old man presented with dyspnea and cough of three weeks duration. Examination revealed sinus tachycardia, distant heart sounds and elevated jugular venous pressure. Chest X-ray showed widened mediastinum. Transthoracic echocardiogram (TTE noted large pericardial effusion with tamponade physiology. Therapeutic pericardiocentesis yielded hemorrhagic fluid. Computed tomography (CT of the chest showed persistent pericardial effusion and a left anterior mediastinal mass. Left anterior thoracotomy, pericardial window and left anterior mediastinotomy were done, revealing a well-encapsulated gelatinous tumor originating from the pericardium. Histology and immunohistochemical profile showed the tumor to be a monophasic synovial sarcoma. Fluorescent in-situ hybridization (FISH was positive for SS18 (SYT gene rearrangement on chromosome 18q11, substantiating the diagnosis. Work-up for metastases was negative. Neo-adjuvant chemotherapy with high dose ifosfamide led to substantial reduction in the size of the tumor. The patient underwent surgical resection and external beam radiation therapy (EBRT post surgery. He had symptom-free survival for 8 months prior to local recurrence. This was managed with left lung upper lobectomy and follow-up chemotherapy with docetaxel. The patient is currently stable with an acceptable functional status. Conclusion: In patients with pericardial effusions of unknown etiology, multiple modalities of cardiac imaging must be employed if there is suspicion of a pericardial mass. CT and magnetic resonance imaging (MRI are useful to evaluate for pericardial thickening or masses in addition to TTE. Treatment of synovial

  19. Screening US and CT for blunt abdominal trauma: A retrospective study

    Energy Technology Data Exchange (ETDEWEB)

    Marco, Giuseppetti Gian [Institute of Radiology, Polytechnic University of Marche Medical School, Umberto I Hospital, Ancona (Italy)]. E-mail: gm.giuseppetti@ao-umbertoprimo.marche.it; Diego, Salera [Institute of Radiology, Polytechnic University of Marche Medical School, Umberto I Hospital, Ancona (Italy); Giulio, Argalia [Institute of Radiology, Polytechnic University of Marche Medical School, Umberto I Hospital, Ancona (Italy); Luca, Salvolini [Institute of Radiology, Polytechnic University of Marche Medical School, Umberto I Hospital, Ancona (Italy)

    2005-10-01

    Objective: To assess the accuracy of screening US and CT in patients with blunt abdominal trauma admitted to the trauma centre of our General Hospital. Materials and method: The abdominal US reports of 864 primary trauma patients (139 with major and 725 with minor injuries) and 162 CT reports of a subgroup of the same subjects (64 with major and 98 with minor injuries) were reviewed and compared to the best available reference standard. The accuracy of screening US was assessed by evaluating its overall ability to distinguish negative from positive cases by showing at least one of the lesions documented by the reference standard and its specific ability to depict all lesions; CT reports were evaluated only for the method's performance in depicting all lesions. Results: Screening US exhibited a satisfactory overall ability to distinguish negative from positive patients (91.5% sensitivity and 97.5% specificity in major trauma patients versus 73.3% sensitivity and 98.1% specificity in the minor trauma group) and a satisfactory specific ability to depict all injuries in major trauma patients. In minor trauma cases sensitivity was satisfactory for free fluid but unsatisfactory for organ injuries. Of the 21/864 false negative reports (5 in patients with major and 16 in cases with minor traumas), only one affected patient management, a major trauma case, by delaying an emergency laparotomy. The performance of CT in detecting each single lesion was predictably excellent in both patient groups. Conclusion: Its satisfactory accuracy for major trauma suggests that US could be employed not only to screen cases for emergency laparotomy but also as an alternative to CT. However, since major traumatic injuries generally carry an imperative indication for CT, especially as regards neurological, thoracic and skeletal evaluation, US should be employed to perform a prompt preliminary examination using a simplified technique in the emergency room simultaneously with resuscitation.

  20. Screening US and CT for blunt abdominal trauma: A retrospective study

    International Nuclear Information System (INIS)

    Objective: To assess the accuracy of screening US and CT in patients with blunt abdominal trauma admitted to the trauma centre of our General Hospital. Materials and method: The abdominal US reports of 864 primary trauma patients (139 with major and 725 with minor injuries) and 162 CT reports of a subgroup of the same subjects (64 with major and 98 with minor injuries) were reviewed and compared to the best available reference standard. The accuracy of screening US was assessed by evaluating its overall ability to distinguish negative from positive cases by showing at least one of the lesions documented by the reference standard and its specific ability to depict all lesions; CT reports were evaluated only for the method's performance in depicting all lesions. Results: Screening US exhibited a satisfactory overall ability to distinguish negative from positive patients (91.5% sensitivity and 97.5% specificity in major trauma patients versus 73.3% sensitivity and 98.1% specificity in the minor trauma group) and a satisfactory specific ability to depict all injuries in major trauma patients. In minor trauma cases sensitivity was satisfactory for free fluid but unsatisfactory for organ injuries. Of the 21/864 false negative reports (5 in patients with major and 16 in cases with minor traumas), only one affected patient management, a major trauma case, by delaying an emergency laparotomy. The performance of CT in detecting each single lesion was predictably excellent in both patient groups. Conclusion: Its satisfactory accuracy for major trauma suggests that US could be employed not only to screen cases for emergency laparotomy but also as an alternative to CT. However, since major traumatic injuries generally carry an imperative indication for CT, especially as regards neurological, thoracic and skeletal evaluation, US should be employed to perform a prompt preliminary examination using a simplified technique in the emergency room simultaneously with resuscitation

  1. Post-traumatic osteomyelitis

    International Nuclear Information System (INIS)

    Only 24 patients with post-traumatic osteomyelitis were found from records covering a period of five years. Twenty-two of them with complete medical histories are reviewed here. The radiographs were usually taken through plaster of Paris, and therefore the radiological diagnosis was established later than the clinical one in half of the cases. There were only four cases with a true delay. The primary radiological signs leading to the osteomyelitis diagnosis appeared on average 4.3 months after the assumed time of infection. It is our feeling that the current widespread use of antibiotics causes the diagnosis to be delayed even more than it was in the days of haematogenous osteomyelitis. Continuous formation of periosteal new bone layers indicated poorer prospects for healing of the osteomyelitis. (orig.)

  2. Post-traumatic syringomyelia

    Directory of Open Access Journals (Sweden)

    Agrawal Amit

    2007-01-01

    Full Text Available Progressive post-traumatic cystic syringomyelia is an uncommon and increasingly recognized cause of morbidity following spinal cord injury. We hereby report a 35-year-old gentleman who sustained wedge compression fracture of L-1 vertebral body 15 years back and had complete paraplegia with bowel/bladder involvement. The neurological deficit recovered with minimal residual motor deficits and erectile dysfunction. He presented now with increasing neurological deficits associated with pain and paresthesia. The MRI spine showed a syrinx extending from the site of injury up to the medulla. He underwent a syringo-peritoneal shunt and at follow-up his pain and motor functions had improved but erectile dysfunction was persisting.

  3. Role of contrast-enhanced helical CT in the evaluation of acute thoracic aortic injuries after blunt chest trauma

    Energy Technology Data Exchange (ETDEWEB)

    Scaglione, M.; Pinto, A.; Pinto, F.; Romano, L.; Ragozzino, A. [Dept. of Emergency Radiology, Cardarelli Hospital, Naples (Italy); Grassi, R. [Dept. of Radiology, Faculty of Medicine, Naples (Italy)

    2001-12-01

    The purpose of this retrospective study was to determine the value of contrast-enhanced helical CT for detecting and managing acute thoracic aortic injury (ATAI). Between June 1995 and February 2000, 1419 consecutive chest CT examinations were performed in the setting of major blunt trauma. The following CT findings were considered indicative of ATAI: intimal flap; pseudoaneurysm; contour irregularity; lumen abnormality; and extravasation of contrast material. On the basis of these direct findings no further diagnostic investigations were performed. Isolated mediastinal hematoma on CT scans was considered an indirect sign of ATAI: In these cases, thoracic aortography was performed even if CT indicated normal aorta. Seventy-seven patients had abnormal CT scans: Among the 23 patients with direct CT signs, acute thoracic aortic injuries was confirmed at thoracotomy in 21. Two false-positive cases were observed. The 54 remaining patients had isolated mediastinal hematoma without aortic injuries at CT and corresponding negative angiograms. The 1342 patients with negative CT scans were included in the 8-month follow-up program and did not show any adverse sequela based on clinical and radiographic criteria. Contrast-enhanced helical CT has a critical role in the exclusion of thoracic aortic injuries in patient with major blunt chest trauma and prevents unnecessary thoracic aortography. Direct CT signs of ATAI do not require further diagnostic investigations to confirm the diagnosis: Isolated aortic bands or contour vessel abnormalities should be first considered as possible artifacts or related to non-traumatic etiologies especially when mediastinal hematoma is absent. In cases of isolated mediastinal hematoma other possible sources of bleeding should be considered before directing patients to thoracic aortography. (orig.)

  4. Role of contrast-enhanced helical CT in the evaluation of acute thoracic aortic injuries after blunt chest trauma

    International Nuclear Information System (INIS)

    The purpose of this retrospective study was to determine the value of contrast-enhanced helical CT for detecting and managing acute thoracic aortic injury (ATAI). Between June 1995 and February 2000, 1419 consecutive chest CT examinations were performed in the setting of major blunt trauma. The following CT findings were considered indicative of ATAI: intimal flap; pseudoaneurysm; contour irregularity; lumen abnormality; and extravasation of contrast material. On the basis of these direct findings no further diagnostic investigations were performed. Isolated mediastinal hematoma on CT scans was considered an indirect sign of ATAI: In these cases, thoracic aortography was performed even if CT indicated normal aorta. Seventy-seven patients had abnormal CT scans: Among the 23 patients with direct CT signs, acute thoracic aortic injuries was confirmed at thoracotomy in 21. Two false-positive cases were observed. The 54 remaining patients had isolated mediastinal hematoma without aortic injuries at CT and corresponding negative angiograms. The 1342 patients with negative CT scans were included in the 8-month follow-up program and did not show any adverse sequela based on clinical and radiographic criteria. Contrast-enhanced helical CT has a critical role in the exclusion of thoracic aortic injuries in patient with major blunt chest trauma and prevents unnecessary thoracic aortography. Direct CT signs of ATAI do not require further diagnostic investigations to confirm the diagnosis: Isolated aortic bands or contour vessel abnormalities should be first considered as possible artifacts or related to non-traumatic etiologies especially when mediastinal hematoma is absent. In cases of isolated mediastinal hematoma other possible sources of bleeding should be considered before directing patients to thoracic aortography. (orig.)

  5. Post-Traumatic Stress Disorder

    Science.gov (United States)

    ... PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat. For Consumers General Information Post-Traumatic Stress Disorder ( NIMH ) Anxiety Information Stress Information Depression Information St. John's Wort Information See more Research ...

  6. Traumatic lesions of pulmonary parenchyma

    International Nuclear Information System (INIS)

    Five cases of post-traumatic pulmonary lesions (contusion, laceration and hematoma) are presented. The pathophysiology, radiological aspects and differential diagnosis are reviewed. The benign evolution showing the absorption in short time, without medical interference is emphasized. (Author)

  7. Traumatic Brain Injury Registry (TBI)

    Data.gov (United States)

    Department of Veterans Affairs — As the number of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Traumatic Brain Injury (TBI) patients has grown, so has the need to track and monitor...

  8. Comparison of subjective, pharmacokinetic, and physiologic effects of marijuana smoked as joints and blunts

    OpenAIRE

    Cooper, Ziva D; Haney, Margaret

    2009-01-01

    Recent increases in marijuana smoking among the young adult population have been accompanied by the popularization of smoking marijuana as blunts instead of as joints. Blunts consist of marijuana wrapped in tobacco leaves, whereas joints consist of marijuana wrapped in cigarette paper. To date, the effects of marijuana smoked as joints and blunts have not been systematically compared. The current within-subject, randomized, double-blind, placebo-controlled study sought to directly compare the...

  9. Isolated Multiple Fragmented Cricoid Fracture Associated with External Blunt Neck Trauma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung Hoon; Hwang, Yoon Joon; Kim, Yong Hoon; Seo, Jung Wook; Cho, Hyeon Je; Kim, Yeon Soo [Inje University School of Medicine, Ilsan Paik Hospital, Goyang (Korea, Republic of)

    2010-08-15

    Blunt laryngeal trauma is a relatively uncommon but possibly life-threatening injury. An isolated cricoid fracture associated with blunt trauma is rare. We report a case of an isolated multiple fragmented cricoid cartilage fracture that developed in a 20-year-old man after a blunt neck trauma that occurred during a baseball game and was diagnosed by 64-slice multidetector computed tomography (MDCT)

  10. Pediatric minor traumatic brain injury.

    Science.gov (United States)

    Gordon, Kevin E

    2006-12-01

    The literature surrounding minor traumatic brain injury is complex, methodologically challenging, and controversial. Although we lack a consistent standardized definition, the annual rate is likely in excess of 200 per 100,000 children. The proportion of children with minor traumatic brain injury who will require neurosurgery is certainly return to play is currently recommended. The recurrence risk for subsequent concussions is elevated, but there is limited documentation of the effectiveness of preventative efforts. Much remains to be learned. PMID:17178354

  11. Post-traumatic stress disorder

    OpenAIRE

    Jonathan I. Bisson

    2010-01-01

    Post-traumatic stress disorder (PTSD) is characterised by disabling symptoms of re-experiencing a traumatic event, avoidance behaviour, and hyperarousal (e.g., irritability or hypervigilance), lasting at least 1 month. PTSD may affect 10% of women and 5% of men at some stage, and symptoms may persist for several years.Risk factors include major trauma, lack of social support, peritraumatic dissociation, and previous psychiatric or personality factors.

  12. Risks of Brain Injury after Blunt Head Trauma

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2004-06-01

    Full Text Available The association of loss of consciousness (LOC and/or amnesia with traumatic brain injury (TBI identified on CT and TBI requiring acute intervention was evaluated in 2043 children <18 years old enrolled prospectively in a level 1 trauma center ED at University of California, Davis School of Medicine, CA.

  13. Mothers' unresolved trauma blunts amygdala response to infant distress

    Science.gov (United States)

    While the neurobiology of post-traumatic stress disorder has been extensively researched, much less attention has been paid to the neural mechanisms underlying more covert but pervasive types of trauma (e.g., those involving disrupted relationships and insecure attachment). Here, we report on a neur...

  14. Diagnostic accuracy of CT scan in abdominal blunt trauma

    Institute of Scientific and Technical Information of China (English)

    Javad Salimi; Khadyjeh Bakhtavar; Mehdi Solimani; Patrcia Khashayar; Ali Pasha Meysamie; Moosa Zargar

    2009-01-01

    Obiective: To evaluate the sensitivity and specificity of CT scan findings in Patients ith blunt abdominal trauma admitted to the university hospital.Methods: All the atients ith blunt abdominal trauma admitted at a tertiary teaching trauma center in Iran between 2005 and 2007 were enrolled in this study.In the absence of any clinical anifestations,he patients underwent a diagnostic CT scan.Laparatomy was performed in those with positive CT results.Others were observed for 48 hours and discharged in case no problem as reported;otherwise they underwent laparatomy.Information on patients'demographic ata,mechanism of trauma,indication for CT scan,CT scan findings,results of laparotomy ere gathered.The sensitivity,specificity and accuracy of the CT-scan images in regard ith the organ injured were calculated.The sensitivity,specificity and accuracy of the T scan were calculated in each case.Results: CT Scan had the highest sensitivity for etecting the injuries to liver (100%) and spleen (86.6%).The specificity of the method or detecting retroperitoneal hematoma (100%) and injuries to kidney (93.5%) was higher han other organs.The accuracy of CT images to detect the injuries to spleen,liver,idney and retroperitoneal hematoma was reported to be 96.1%,94.4%,91.6% and 91.6% espectively.Conclusion: The findings of the present study reveal that CT scan could econsidered as a good choice,especially for patients with blunt abdominal trauma in eaching hospitals where the radiologic academic staff is not present in the hospital in the night shifts.

  15. Blunt pancreatic trauma: experience at a rural referral center.

    Science.gov (United States)

    Timberlake, G A

    1997-03-01

    The objective of this study was to compare mechanism of injury, treatment methods, and outcome of blunt pancreas trauma patients transferred from another hospital to those of patients brought directly from the scene. A retrospective review was conducted of 6078 patients treated at a Level I trauma center from 1/1/90 to 12/31/94. Blunt pancreas injury was found in 39 (0.64%) patients (mean age, 33.2 years). Mechanism of injury included 34 (87%) motor vehicle crashes, 3 (8%) motorcycle crashes, and 2 (5%) other injuries. There were 11 transfer patients (28%), and 28 (72%) admitted directly from the scene. Eighty-two per cent of the motor vehicle crash patients were unrestrained, and 35 per cent had ethanol intoxication. Exploratory laparotomy was performed on 32 (82%); eight (25%) required repair or resection; 22 (69%) had trivial injuries, at most requiring drainage; and two (6.3%) exsanguinated. No patients required Whipple resection or pancreatiocojejunostomy. At operation, an average of 2.5 associated intra-abdominal injuries were found. Overall survival was 35 of 39 (90%). Among the patients brought directly to the trauma center, 93 per cent survived, whereas survival among transferred patients was 82 per cent (chi2 = 0.19; P = 0.66). Blunt pancreatic injuries vary in severity, but radical resection is rarely required. Lack of safety restraint and ethanol use are major risk factors. Despite the high likelihood of associated injuries, survivability is high. No difference in outcome was seen between directly admitted and transferred patients. PMID:9036900

  16. Imaging of blunt chest trauma; Bildgebung des stumpfen Thoraxtraumas

    Energy Technology Data Exchange (ETDEWEB)

    Prosch, H. [Medizinische Universitaet Wien, Allgemeines Krankenhaus, Univ.-Klinik fuer Radiologie und Nuklearmedizin, Wien (Austria); Negrin, L. [Medizinische Universitaet Wien, Allgemeines Krankenhaus, Univ.-Klinik fuer Unfallchirurgie, Wien (Austria)

    2014-09-15

    Blunt chest trauma is associated with high morbidity and mortality. Consequently, all patients should be evaluated radiologically after blunt chest trauma to allow timely and appropriate treatment. Conventional chest radiographs and computed tomography (CT) are proven modalities with which to evaluate patients after blunt chest trauma. Over the last several years extended focused assessment with sonography for trauma (eFAST) has gained increasing importance for the initial assessment of seriously injured patients. In the acute phase of severely injured patients eFAST examinations are helpful to exclude pneumothorax, hemothorax and hemopericardium. Chest radiographs may also be used to diagnose a pneumothorax or hemothorax; however, the sensitivity is limited and CT is the diagnostic modality of choice to evaluate severely injured patients. (orig.) [German] Stumpfe Thoraxtraumen gehen mit einer hohen Morbiditaet und Mortalitaet einher. Daher sollten Patienten mit Verdacht auf ein stumpfes Thoraxtrauma rasch radiologisch untersucht werden, damit die entsprechenden therapeutischen Schritte zeitgerecht eingeleitet werden koennen. Zur Abklaerung von Patienten nach einem stumpfen Thoraxtrauma sind seit Jahren das konventionelle Lungenroentgen und die Computertomographie bewaehrte Verfahren. In den letzten Jahren hat die fokussierte Ultraschalluntersuchung (eFAST, Extended Focused Assessment with Sonography for Trauma) von schwerverletzten Patienten vermehrt an Bedeutung gewonnen. Durch eine eFAST-Untersuchung kann in der Akutphase rasch geklaert werden, ob bei dem Patienten ein therapiebeduerftiger Pneumothorax, Haematoperikard oder Haematothorax vorliegen. Auch das Lungenroentgen wird zur Diagnose eines Pneumothorax oder Haematothorax eingesetzt, wenngleich seine Sensitivitaet deutlich eingeschraenkt ist. Die CT ist das diagnostische Verfahren der Wahl, um v. a. Patienten mit einem schweren Thoraxtrauma abzuklaeren. (orig.)

  17. Crack tip blunting and cleavage under dynamic conditions

    Science.gov (United States)

    Rajan, V. P.; Curtin, W. A.

    2016-05-01

    In structural materials with both brittle and ductile phases, cracks often initiate within the brittle phase and propagate dynamically towards the ductile phase. The macroscale, quasistatic toughness of the material thus depends on the outcome of this microscale, dynamic process. Indeed, dynamics has been hypothesized to suppress dislocation emission, which may explain the occurrence of brittle transgranular fracture in mild steels at low temperatures (Lin et al., 1987). Here, crack tip blunting and cleavage under dynamic conditions are explored using continuum mechanics and molecular dynamics simulations. The focus is on two questions: (1) whether dynamics can affect the energy barriers for dislocation emission and cleavage, and (2) what happens in the dynamic "overloaded" situation, in which both processes are energetically possible. In either case, dynamics may shift the balance between brittle cleavage and ductile blunting, thereby affecting the intrinsic ductility of the material. To explore these effects in simulation, a novel interatomic potential is used for which the intrinsic ductility is tunable, and a novel simulation technique is employed, termed as a "dynamic cleavage test", in which cracks can be run dynamically at a prescribed energy release rate into a material. Both theory and simulation reveal, however, that the intrinsic ductility of a material is unaffected by dynamics. The energy barrier to dislocation emission appears to be identical in quasi-static and dynamic conditions, and, in the overloaded situation, ductile crack tip behavior ultimately prevails since a single emission event can blunt and arrest the crack, preventing further cleavage. Thus, dynamics cannot embrittle a ductile material, and the origin of brittle failure in certain alloys (e.g., mild steels) appears unrelated to dynamic effects at the crack tip.

  18. Diagnosis and management of colonic injuries following blunt trauma

    Institute of Scientific and Technical Information of China (English)

    Yi-Xiong Zheng; Li Chen; Si-Feng Tao; Ping Song; Shao-Ming Xu

    2007-01-01

    AIM: To retrospectively evaluate the preoperative diagnostic approaches and management of colonic injuries following blunt abdominal trauma.METHODS: A total of 82 patients with colonic injuries caused by blunt trauma between January 1992 and December 2005 were enrolled. Data were collected on clinical presentation, investigations, diagnostic methods,associated injuries, and operative management. Colonic injury-related mortality and abdominal complications were analyzed.RESULTS: Colonic injuries were caused mainly by motor vehicle accidents. Of the 82 patients, 58 (70.3%) had other associated injuries. Laparotomy was performed within 6 h after injury in 69 cases (84.1%), laparoscopy in 3 because of haemodynamic instability. The most commonly injured site was located in the transverse colon. The mean colon injury scale score was 2.8. The degree of faecal contamination was classified as mild in 18 (22.0%), moderate in 42 (51.2%), severe in 14 (17.1%), and unknown in 8 (9.8%) cases. Sixty-seven patients (81.7%) were treated with primary repair or resection and anastomosis. Faecal stream diversion was performed in 15 cases (18.3%). The overall mortality rate was 6.1%. The incidence of colonic injuryrelated abdominal complications was 20.7%. The only independent predictor of complications was the degree of peritoneal faecal contamination (P = 0.02).CONCLUSION: Colonic injuries following blunt trauma are especially important because of the severity and complexity of associated injuries. A thorough physical examination and a combination of tests can be used to evaluate the indications for laparotomy. One stage management at the time of initial exploration is most often used for colonic injuries.

  19. Suboptimal maternal nutrition during early-to-mid gestation in the sheep enhances pericardial adiposity in the near-term fetus.

    Science.gov (United States)

    Ojha, Shalini; Symonds, Michael E; Budge, Helen

    2015-11-01

    Manipulation of the maternal diet at defined stages of gestation influences long-term health by inducing changes in fetal adipose tissue development, characterised as possessing brown and white adipocytes. We determined whether suboptimal maternal nutrition in early-to-mid gestation, followed by ad libitum feeding until term, increases adiposity in the pericardial depot of the sheep fetus. Pericardial adipose tissue was sampled from near-term (140 days) fetuses delivered to mothers fed either 100% (C) or 60% (i.e. nutrient restricted (NR)) of their total metabolisable requirements from 28 to 80 days gestation and then fed ad libitum. Adipose tissue mass, uncoupling protein (UCP) 1 and gene expression of brown and white adipogenic genes was measured. Total visceral and pericardial adiposity was increased in offspring born to NR mothers. The abundance of UCP1 was increased, together with those genes involved in brown (e.g. BMP7 and C/EBPβ) and white (e.g. BMP4 and C/EBPα) adipogenesis, whereas insulin receptor gene expression was downregulated. In conclusion, suboptimal maternal nutrition between early-to-mid gestation followed by ad libitum feeding enhances pericardial adiposity near to term. A combination of raised UCP1 and adipose tissue mass could improve survival following cold exposure at birth. In the longer term, this enhanced adipogenic potential could predispose to greater pericardial adiposity. PMID:24952585

  20. Improvement of airfoil trailing edge bluntness noise model

    DEFF Research Database (Denmark)

    Zhu, Wei Jun; Shen, Wen Zhong; Sørensen, Jens Nørkær; Leloudas, Giorgos

    2016-01-01

    In this article, airfoil trailing edge bluntness noise is investigated using both computational aero-acoustic and semi-empirical approach. For engineering purposes, one of the most commonly used prediction tools for trailing edge noise are based on semi-empirical approaches, for example, the Brooks......, Pope, and Marcolini airfoil noise prediction model developed by Brooks, Pope, and Marcolini (NASA Reference Publication 1218, 1989). It was found in previous study that the Brooks, Pope, and Marcolini model tends to over-predict noise at high frequencies. Furthermore, it was observed that this was...

  1. Optimum shape of a blunt forebody in hypersonic flow

    Science.gov (United States)

    Maestrello, L.; Ting, L.

    1989-01-01

    The optimum shape of a blunt forebody attached to a symmetric wedge or cone is determined. The length of the forebody, its semi-thickness or base radius, the nose radius and the radius of the fillet joining the forebody to the wedge or cone are specified. The optimum shape is composed of simple curves. Thus experimental models can be built readily to investigate the utilization of aerodynamic heating for boundary layer control. The optimum shape based on the modified Newtonian theory can also serve as the preliminary shape for the numerical solution of the optimum shape using the governing equations for a compressible inviscid or viscous flow.

  2. CT diagnosis of unsuspected pneumothorax after blunt abdominal trauma

    International Nuclear Information System (INIS)

    Review of abdominal CT scans for evaluation of blunt abdominal trauma yielded 35 cases of pneumothorax, 10 of which had not been diagnosed before CT by clinical examination of plain radiographs. Of the 10 cases initially diagnosed on CT, seven required tube thoracostomy for treatment of the pneumothorax. CT detection of pneumothorax is especially important if mechanical assisted ventilation or general anesthesia is used. Demonstration of pneumothorax requires viewing CT scans of the upper abdomen (lower thorax) at lung windows in addition to the usual soft-tissue windows

  3. Forensic expertise of thoracic aorta, heart and pericardial injuries in car-occupant fatalities

    Directory of Open Access Journals (Sweden)

    Nikolić Slobodan

    2009-01-01

    Full Text Available Introduction. Forensic expertise has not specified with certainty any specific injury among fatally injured frontal car-occupants in frontal car collisions. Objective. To establish if blunt injuries of thoracic aorta, heart, and pericardium could be used as predictors where the fatally injured car-occupant was at the moment of car-collision. Methods. A retrospective autopsy study was performed. The subjects were fatally injured car-drivers, front-seat and rearseat passengers in head-on car collisions. In each of them we analyzed the injuries of thoracic aorta, heart and pericardium. Results. 492 subjects were analyzed (378 male and 104 female: 239 car-drivers, 194 front-seat and 49 rear-seat passengers. The isthmus of aorta was the commonest site of simple blunt rupture among car-drivers and front-seat passengers. Among more than half of the observed subject, there was aortic blunt rupture as concomitant injury with heart and pericardium injuries. Heart and pericardium ruptures were most common among fatally injured car-drivers. Most frequently injured part of the heart was the right atrium. Injuries of thoracic aorta, heart and pericardium indicated a higher probability that the fatally injured would be the car-driver (λ=0.818; df=2; p=0.011, λ=0.906; df=2; p=0.000, and λ=0.951; df=2; p=0.000; this was also pointed out by the rupture of the right atrium and multiple ruptures of the thoracic aorta (λ=0.966; df=2; p=0.000 and λ=0.918; df=2; p=0.009. The concomitant injuries of the thoracic aorta with thoracic spine, sternum and heart pointed out that the injured person was the car-driver (λ=0.971; df=4; p=0.007, λ=0.974; df=4; p=0.013 and λ=0.958; df=4; p=0.000, as well as the concomitant injuries of heart and sternal fracture (λ=0.960; df=4; p=0.001. The probability of about 80% that the fatally injured person in head-on collisions was a car-driver was pointed out by concomitant blunt thoracic aorta rupture with fractured sternum and

  4. Cannabis Problem Experiences Among Users of the Tobacco-Cannabis Combination Known As Blunts

    Science.gov (United States)

    Fairman, Brian J.

    2015-01-01

    Background In most of the world, cannabis smokers mix loose tobacco inside a joint, pipe, spliff, or cone. More recently, a ‘blunt’ formulation combines these two drugs by inserting cannabis into a hollowed-out cigar. Epidemiological research linking simultaneous use of these two drugs and the development of cannabis use disorders (CUD) remains unclear. This study estimates associations linking blunt smoking with levels and subtypes of cannabis problems. Methods Cross-sectional data on 27,767 past-year cannabis users were analyzed from the US National Survey on Drug Use and Health (NSDUH) conducted from 2009–2012. Ten self-reported items of DSM-IV CUD features elicited a single latent trait of cannabis problem (CP) severity, which was then regressed on past-year blunt smoking and past-month blunt frequency measures within the context of a conceptual model. Differential item functioning (DIF) analysis evaluated potential bias in CP feature response by blunt smoking history. Results Past-year blunt smoking was associated with higher CP severity compared to cannabis users who did not smoke blunts. Days of blunt smoking in the past month also predicted higher CP severity than less frequent blunt use. Those smoking blunts experienced more subjectively felt tolerance and having spent more time obtaining or using cannabis, but were less likely to experience other problems, even at the same level of CP severity. Conclusions These findings suggest smoking blunts might promote the development of problematic cannabis use. Responses to cannabis problems differed by history of blunt smoking, possibly implicating an influence of tobacco on measurement of cannabis use disorders. PMID:25746234

  5. Acute traumatic patellar dislocation.

    Science.gov (United States)

    Duthon, V B

    2015-02-01

    Inaugural traumatic patellar dislocation is most often due to trauma sustained during physical or sports activity. Two-thirds of acute patellar dislocations occur in young active patients (less than 20 years old). Non-contact knee sprain in flexion and valgus is the leading mechanism in patellar dislocation, accounting for as many as 93% of all cases. The strong displacement of the patella tears the medial stabilizing structures, and notably the medial patellofemoral ligament (MPFL), which is almost always injured in acute patellar dislocation, most frequently at its femoral attachment. Lateral patellar glide can be assessed with the knee in extension or 20° flexion. Displacement by more than 50% of the patellar width is considered abnormal and may induce apprehension. Plain X-ray and CT are mandatory to diagnose bony risk factors for patellar dislocation, such as trochlear dysplasia or increased tibial tubercle-trochlear groove distance (TT-TG), and plan correction. MRI gives information on cartilage and capsulo-ligamentous status for treatment planning: free bodies or osteochondral fracture have to be treated surgically. If patellar dislocation occurs in an anatomically normal knee and osteochondral fracture is ruled out on MRI, non-operative treatment is usually recommended. PMID:25592052

  6. The role of computed tomography in blunt hepatic injury

    International Nuclear Information System (INIS)

    Computed tomography (CT) images and medical records of 283 patients with blunt abdominal trauma were reviewed. There were 67 patients with hepatic injury. Liver was the most frequently injured organ in blunt abdominal trauma. Most hepatic injuries occurred in the right lobe of the liver. Of the 67 patients with hepatic injury, 60 patients had associated other injuries. There was a high incidence of associated lung injuries (35.8 %). Of importance is the high incidence of associated head injuries (22.4 %), because, in some patients such as those with concomitant head trauma, abdominal symptom is not obvious. The associated hemoperitoneum were correlated with the mode of therapy used in each case (operative vs. nonoperative). 32 patients with hepatic injury but no hemoperitoneum were managed nonoperatively. 9 patients with hepatic injury and little hemoperitoneum were also managed conservatively. 22 patients with high density hemoperitoneum were surgically treated. By combining information on the clinical state of the patient and CT finding, therapy of hepatic injury can be individualized and the incidence of nontherapeutic laparotomies decreased. (author)

  7. Evolving Role of Endoscopic Retrograde Cholangiopancreatography in Management of Extrahepatic Hepatic Ductal Injuries due to Blunt Trauma: Diagnostic and Treatment Algorithms

    Directory of Open Access Journals (Sweden)

    Nikhil P. Jaik

    2007-11-01

    Full Text Available Extrahepatic hepatic ductal injuries (EHDIs due to blunt abdominal trauma are rare. Given the rarity of these injuries and the insidious onset of symptoms, EHDI are commonly missed during the initial trauma evaluation, making their diagnosis difficult and frequently delayed. Diagnostic modalities useful in the setting of EHDI include computed tomography (CT, abdominal ultrasonography (AUS, nuclear imaging (HIDA scan, and cholangiography. Traditional options in management of EHDI include primary ductal repair with or without a T-tube, biliary-enteric anastomosis, ductal ligation, stenting, and drainage. Simple drainage and biliary decompression is often the most appropriate treatment in unstable patients. More recently, endoscopic retrograde cholangiopancreatography (ERCP allowed for diagnosis and potential treatment of these injuries via stenting and/or papillotomy. Our review of 53 cases of EHDI reported in the English-language literature has focused on the evolving role of ERCP in diagnosis and treatment of these injuries. Diagnostic and treatment algorithms incorporating ERCP have been designed to help systematize and simplify the management of EHDI. An illustrative case is reported of blunt traumatic injury involving both the extrahepatic portion of the left hepatic duct and its confluence with the right hepatic duct. This injury was successfully diagnosed and treated using ERCP.

  8. Measurements of pericardial adipose tissue using contrast enhanced cardiac multidetector computed tomography—comparison with cardiac magnetic resonance imaging

    DEFF Research Database (Denmark)

    Elming, Marie Bayer; Lønborg, Jacob; Rasmussen, Thomas;

    2013-01-01

    Recent studies have suggested that pericardial adipose tissue (PAT) located in close vicinity to the epicardial coronary arteries may play a role in the development of coronary artery disease. PAT has primarily been measured with cardiac magnetic resonance imaging (CMRI) or with non......-contrast cardiac multidetector computered tomography (MDCT) images. The aim of this study was to validate contrast MDCT derived measures of total PAT volume by a comparison to CMRI. In 52 patients, aged 60 years (34-81 years), Body Mass Index 28 kg/m(2) (18-39), and with stable ischemic heart disease, paired MDCT...

  9. International Society for Traumatic Stress Studies

    Science.gov (United States)

    ... Traumatic Stress Studies Log In Search for: International Society for Traumatic Stress Studies Assessing Trauma Acute Stress ... effects of severe psychological trauma on individuals and society. http://www.listeningtotrauma.org/ view full calendar Join ...

  10. Traumatic corneal endothelial rings from homemade explosives.

    Science.gov (United States)

    Ng, Soo Khai; Rudkin, Adam K; Galanopoulos, Anna

    2013-08-01

    Traumatic corneal endothelial rings are remarkably rare ocular findings that may result from blast injury. We present a unique case of bilateral traumatic corneal endothelial rings secondary to blast injury from homemade explosives. PMID:23474743

  11. Interventional Treatment for Post-traumatic Headache.

    Science.gov (United States)

    Conidi, Francis X

    2016-06-01

    Post-traumatic headache (migraine) is the most common symptom of concussion and traumatic brain injury. An expert opinion-based review along with a literature review (PubMed) was conducted looking at known interventional procedures for post-traumatic headache using the keywords post-traumatic headache, post-traumatic migraine headache, concussion, mild traumatic brain injury, and traumatic brain injury and the following categories: mechanism, pathophysiology, treatment, physical therapy, neurostimulation, Botox@/Onabotulinum toxin, and surgical intervention. The results returned a total of 181 articles of which 52 were selected. None of the articles included randomized placebo-controlled studies, and most were either prospective or retrospective case analysis and/or review articles or consensus opinion papers, with most studies yielding positive results. Despite a lack of hard evidence, interventional procedures, alone or in combination, appear to be an effective treatment for post-traumatic headaches. PMID:27130542

  12. Traumatic Brain Injury (TBI): Moderate or Severe

    Science.gov (United States)

    Traumatic Brain Injury (TBI) Moderate or Severe Definition A TBI is classified as moderate or severe when a patient experiences ... skull and enters the brain Defense and Veterans Brain Injury Center PATFIAE MN TI LSI ES Traumatic Brain ...

  13. Traumatic Brain Injury (TBI) Data and Statistics

    Science.gov (United States)

    ... Submit Search The CDC Injury Prevention & Control: Traumatic Brain Injury & Concussion Note: Javascript is disabled or is not ... please visit this page: About CDC.gov . Traumatic Brain Injury & Concussion Basic Information Get the Facts Signs and ...

  14. Hepatic Enzyme Decline after Pediatric Blunt Trauma: A Tool for Timing Child Abuse?

    Science.gov (United States)

    Baxter, Amy L.; Lindberg, Daniel M.; Burke, Bonnie L.; Shults, Justine; Holmes, James F.

    2008-01-01

    Objectives: Previous research in adult patients with blunt hepatic injuries has suggested a pattern of serum hepatic transaminase concentration decline. Evaluating this decline after pediatric blunt hepatic trauma could establish parameters for estimating the time of inflicted injuries. Deviation from a consistent transaminase resolution pattern…

  15. Computed tomography of the chest in blunt thoracic trauma: results of a prospective study

    International Nuclear Information System (INIS)

    Blunt thoracic injuries detected by computed tomography of the chest infrequently require immediate therapy. If immediate therapy is needed, findings will be visible on plain roentgenograms or on clinical exam. Routine Computed Tomography of the chest in blunt trauma is not recommended but may be helpful in selected cases. (N.C.)

  16. Use of Marijuana and Blunts among Adolescents: 2005. The NSDUH Report

    Science.gov (United States)

    Substance Abuse and Mental Health Services Administration, 2007

    2007-01-01

    This report focuses on past month marijuana and blunt use among youths aged 12 to 17.7 Data are presented by demographic and academic characteristics. All findings are based on data from the 2005 NSDUH. The National Survey on Drug Use and Health (NSDUH) includes questions on the use of marijuana and blunts. Respondents who reported lifetime use of…

  17. Traumatic and Non-traumatic Knee Complaints in General Practice

    OpenAIRE

    Kastelein, Marlous

    2013-01-01

    textabstractGeneral practitioners (GPs) are frequently consulted by patients with various types of knee complaints. The incidence of these knee complaints presented in Dutch general practice is about 13.7 per 1000 registered patients per year with a prevalence of 19.0 per 1000 patients per year. About 80% of these knee complaints are of non-­‐traumatic origin. The most common non-­‐traumatic diagnosis varies with age; adolescents and young adults suffer mostly from patellofemoral pain syndrom...

  18. Subthreshold Post-Traumatic Stress Disorder

    OpenAIRE

    Eylem Ozten; Gokben Hizli Sayar

    2015-01-01

    Post-traumatic stress disorder is a very broad category among mental disorders. Since its inclusion in DSM-III, the diagnostic criteria of post-traumatic stress disorder has undergone a number of changes. The diagnosis and treatment of people who have some symptoms of post-traumatic stress disorder without meeting full criteria still remains controversial. Although subthreshold post-traumatic stress disorder has been debated since it was first defined, the presence of subthreshold post-trauma...

  19. Knowledge of Traumatic Brain Injury among Educators

    Science.gov (United States)

    Ernst, William J.; Gallo, Adrienne B.; Sellers, Amanda L.; Mulrine, Jessica; MacNamara, Luciana; Abrahamson, Allison; Kneavel, Meredith

    2016-01-01

    The purpose of this study is to determine knowledge of traumatic brain injury among educators. Few studies have examined knowledge of traumatic brain injury in this population and fewer still have included a substantial proportion of general education teachers. Examining knowledge of traumatic brain injury in educators is important as the vast…

  20. Post-Traumatic Stress Disorder Basics

    Science.gov (United States)

    ... Don’t Hurt Yourself For More Information Share Post-Traumatic Stress Disorder Basics Download PDF Download ePub Order a free ... might have post-traumatic stress disorder. What is post-traumatic stress disorder, or PTSD? PTSD is a real illness. You ...

  1. Lymphangiopathy in neurofibromatosis 1 manifesting with chylothorax, pericardial effusion, and leg edema

    Directory of Open Access Journals (Sweden)

    Finsterer J

    2013-09-01

    Full Text Available Josef Finsterer,1 Claudia Stollberger,2 Elisabeth Stubenberger,3 Sasan Tschakoschian4 1Krankenanstalt Rudolfstiftung, Vienna, Austria; 2Medical Department, Krankenanstalt Rudolfstiftung, Vienna, Austria; 3Thoracic Surgery Department, Vienna, Austria; 4Interne Lungenabt, Vienna, Austria Background: This case report documents the affliction of the lymph vessels as a phenotypic feature of neurofibromatosis-1 (NF-1. Methodology: Routine transthoracic echocardiography, computed tomography scan of the thorax, magnetic resonance angiography of the renal arteries, and conventional digital subtraction angiography were applied. Comprehensive NF-1 mutation analysis was carried out by fluorescence in situ hybridization analysis, long-range reverse transcriptase polymerase chain reaction, and multiple-ligation probe assay. All other investigations were performed using routine, well-established techniques. Results: The subject is a 34-year-old, half-Chinese male; NF-1 was suspected at age 15 years for the first time. His medical history included preterm birth, mild facial dysmorphism, "café au lait" spots, subcutaneous and paravertebral fibromas, multifocal tachycardia, atrial fibrillation, and heart failure in early infancy. Noncalcified bone fibromas in the femur and tibia were detected at age 8 years. Surgical right leg lengthening was carried out at age 11 years. Bilateral renal artery stenosis, stenosis and aneurysm of the superior mesenteric artery, and an infrarenal aortic stenosis were detected at age 15 years. Leg edema and ectasia of the basilar artery were diagnosed at age 18 years. After an episode with an erysipela at age 34 years, he developed pericardial and pleural effusion during a 4-month period. Stenosis of the left subclavian vein at the level of thoracic duct insertion was detected. After repeated pleural punctures, pleural effusion was interpreted as chylothorax. Reduction of lymph fluid production by diet and injection of talcum into

  2. The restoration of traumatized teeth.

    Science.gov (United States)

    Liddelow, G; Carmichael, G

    2016-03-01

    The restoration of a traumatized tooth may require minimally invasive or more extensive treatment options. The majority of injuries occur in the younger population, so management should consider the long-term outcome, failure and future treatment needs over the course of, often, many decades. The aim should be to provide a tooth-restoration complex that closely mimics the functional and aesthetic qualities of an intact tooth for as long as possible. This narrative review will assess the relevant literature pertinent to restoration of traumatized teeth in order to provide guidance for the practising clinician. PMID:26923452

  3. Drug-Intake Methods and Social Identity: The Use of Marijuana in Blunts among Southeast Asian Adolescents and Emerging Adults

    Science.gov (United States)

    Soller, Brian; Lee, Juliet P.

    2010-01-01

    This article examines why Southeast Asian American adolescents and emerging adults in two urban settings prefer to use "blunts," or hollowed-out cigars filled with marijuana, over other methods of drug intake. Rationales for preferring blunts were both instrumental and social. Blunts allowed users to more easily share marijuana, the preferred drug…

  4. Isolated pancreatic injury following blunt abdominal trauma in a child

    Directory of Open Access Journals (Sweden)

    Jain Sandeep

    2007-01-01

    Full Text Available Pancreatic injury following blunt abdominal trauma is rare as compared to other visceral organs. Isolated injury to the pancreas is even more rare. The clinical presentation is subtle resulting in delayed treatment with high morbidity and mortality. A three-year-old female child presented with vomiting 18h following a motor vehicle accident. She was hemodynamically stable with no external signs of injury. Investigations revealed hyperamylasemia and isolated grade III pancreatic injury. Laparotomy with distal pancreatic resection and splenectomy was done. A high degree of clinical suspicion with due consideration to the mechanism of injury is the key to good outcome in these patients. Major ductal injury is the critical issue in the management and a number of therapeutic choices are available specific to the location of the insult.

  5. Detection of abdominal bleeding in blunt abdominal trauma

    International Nuclear Information System (INIS)

    Arterial hemorrhage is the most serious immediate complication of blunt abdominal trauma. This paper discusses the detection and localization of active hemorrhage in nonpenetrating injury, as a modification of the technique using technetium-99m sulfur colloid to localize the site of active bleeding in the gastrointestinal tract. Any imaging protocol for suspected hepatosplenic injury can be easily modified to search for active intra-abdominal hemorrhage. The timely detection of unsuspected bleeding improves patient management by allowing the surgeon to reorder his or her treatment priorities. The early detection of clinically unsuspected intra-abdominal, retroperitoneal, or pelvic hemorrhage will identify those patients who may need more definitive diagnostic procedures, interventional angiography for control of bleeding, or surgical intervention. The 500,000-count view of the abdomen and pelvis can be easily incorporated into any existing trauma protocol using technetium-99m sulfur colloid, is of proven value, and adds little additional time to the study

  6. Delayed Presentation of Traumatic Diaphragmatic Hernia: The Evaluation of Surgical Treatment Results

    Directory of Open Access Journals (Sweden)

    Ali Sadrizadeh

    2015-06-01

    Full Text Available Introduction: Diaphragmatic hernia could be caused by congenital disorders, blunt trauma or penetrating injuries. The diagnosis of traumatic diaphragmatic hernia is normally neglected during the first presentation leading to late complications and considerably increased mortality and morbidity among the patients. Materials and Methods: In this retrospective, descriptive study, we reviewed the medical records of patients presented with traumatic diaphragmatic hernia who had undergone surgical operations between 1982-2015 in Ghaem Hospital and Omid Hospital affiliated to Mashhad University of Medical Sciences, Iran. The studied variables included age, gender, clinical symptoms, location of hernia, involved organs, type of imaging modalities, surgical techniques, length of hospital stay, mortality rate and surgical complications. Results: In this study, 38 patients were diagnosed with traumatic diaphragmatic hernia consisting of 28 men and 10 women. In total, 79% and 21% of the patients suffered from penetrating trauma and blunt trauma, respectively. In addition, left-sided, right-sided and bilateral hernias were present in 33%, 4% and 1% of the patients, respectively. The most frequently herniated organ was the stomach, and the most common clinical symptoms were abdominal pain (84% and dyspnea (53%. Initially, chest radiographs were performed on all the patients, and thoracotomy was performed to repair diaphragmatic tears in all the cases (100%. In this study, 3 patients had previously undergone Hartmann’s operation for gangrenous herniated colon, and devolvulation of gastric volvulus had also been performed on 3 patients. The main post-operative complications were reported to be pneumonia and respiratory insufficiency (2 cases, and the mean length of hospital stay was 6 days (5-8 days which was longer (1-2 months in patients with gangrenous bowel (3 patients. Furthermore, no mortality was reported during the course of hospitalization in these

  7. Evaluation after Traumatic Brain Injury

    Science.gov (United States)

    Trudel, Tina M.; Halper, James; Pines, Hayley; Cancro, Lorraine

    2010-01-01

    It is important to determine if a traumatic brain injury (TBI) has occurred when an individual is assessed in a hospital emergency room after a car accident, fall, or other injury that affects the head. This determination influences decisions about treatment. It is essential to screen for the injury, because the sooner they begin appropriate…

  8. Management of partial traumatic hemipelvectomy.

    Science.gov (United States)

    Wang, Guodong; Zhou, Dongsheng; Shen, Wun-Jer; Xin, Maoyuan; He, Jiliang; Li, Qinghu; Tan, Guoqing

    2013-11-01

    Partial traumatic hemipelvectomy is a devastating condition. Although by definition the affected limb is not totally transected from the trunk because of retained soft tissue, the reported mortality rate is actually higher than in complete traumatic hemipelvectomy. Between January 2000 and December 2011, a total of 917 patients were admitted to the authors' institution for pelvic fracture. Seven of these patients met the criteria for partial traumatic hemipelvectomy. All 7 patients had multiple associated injuries and met the criteria for Baskett class IV hypovolemic shock on arrival at the emergency department. The amount of bleeding was the greatest issue, and control of hemorrhage and rapid blood transfusion were the initial goals. Abdominal aorta balloon occlusion, laparotomy and packing, and pelvic external fixation were useful to control bleeding. Two patients died during the initial resuscitation phase. Angiography (digital subtraction or computed tomographic) was performed in 4 patients but did not provide any treatment-altering information. Limb preservation was attempted in 2 patients; both of these patients eventually required hindquarter amputation. One patient died, and the second patient survived after a difficult postoperative course. The best results were obtained in 3 patients who underwent completion of the hindquarter amputation within 24 hours of trauma. All patients became wheelchair dependent, and no patient was able to return to work. Early completion of hindquarter amputation after hemorrhaging has been controlled is recommended in patients with partial traumatic hemipelvectomy. Angiography did not prove useful in decision making. PMID:24200435

  9. Reconsidering Post-Traumatic Stress

    Science.gov (United States)

    Berman, Dene S.; Davis-Berman, Jennifer

    2005-01-01

    This article serves to challenge the prevailing wisdom that suggests that most trauma is followed by post-traumatic stress disorder (PTSD), and is best treated with critical incident stress debriefing (CISD). Instead, recent evidence suggests that many individuals exposed to stress do not experience stress responses. Even those who do, however,…

  10. Hypopituitarism in Traumatic Brain Injury

    DEFF Research Database (Denmark)

    Klose, Marianne; Feldt-Rasmussen, Ulla

    2015-01-01

    While hypopituitarism after traumatic brain injury (TBI) was previously considered rare, it is now thought to be a major cause of treatable morbidity among TBI survivors. Consequently, recommendations for assessment of pituitary function and replacement in TBI were recently introduced. Given the...

  11. Traumatic Brain Injury Inpatient Rehabilitation

    Science.gov (United States)

    Im, Brian; Schrer, Marcia J.; Gaeta, Raphael; Elias, Eileen

    2010-01-01

    Traumatic brain injuries (TBI) can cause multiple medical and functional problems. As the brain is involved in regulating nearly every bodily function, a TBI can affect any part of the body and aspect of cognitive, behavioral, and physical functioning. However, TBI affects each individual differently. Optimal management requires understanding the…

  12. Efficacy of N-acetyl cysteine in traumatic brain injury.

    Science.gov (United States)

    Eakin, Katharine; Baratz-Goldstein, Renana; Pick, Chiam G; Zindel, Ofra; Balaban, Carey D; Hoffer, Michael E; Lockwood, Megan; Miller, Jonathan; Hoffer, Barry J

    2014-01-01

    In this study, using two different injury models in two different species, we found that early post-injury treatment with N-Acetyl Cysteine (NAC) reversed the behavioral deficits associated with the TBI. These data suggest generalization of a protocol similar to our recent clinical trial with NAC in blast-induced mTBI in a battlefield setting, to mild concussion from blunt trauma. This study used both weight drop in mice and fluid percussion injury in rats. These were chosen to simulate either mild or moderate traumatic brain injury (TBI). For mice, we used novel object recognition and the Y maze. For rats, we used the Morris water maze. NAC was administered beginning 30-60 minutes after injury. Behavioral deficits due to injury in both species were significantly reversed by NAC treatment. We thus conclude NAC produces significant behavioral recovery after injury. Future preclinical studies are needed to define the mechanism of action, perhaps leading to more effective therapies in man. PMID:24740427

  13. Efficacy of N-Acetyl Cysteine in Traumatic Brain Injury

    Science.gov (United States)

    Eakin, Katharine; Baratz-Goldstein, Renana; Pick, Chiam G.; Zindel, Ofra; Balaban, Carey D.; Hoffer, Michael E.; Lockwood, Megan; Miller, Jonathan; Hoffer, Barry J.

    2014-01-01

    In this study, using two different injury models in two different species, we found that early post-injury treatment with N-Acetyl Cysteine (NAC) reversed the behavioral deficits associated with the TBI. These data suggest generalization of a protocol similar to our recent clinical trial with NAC in blast-induced mTBI in a battlefield setting [1], to mild concussion from blunt trauma. This study used both weight drop in mice and fluid percussion injury in rats. These were chosen to simulate either mild or moderate traumatic brain injury (TBI). For mice, we used novel object recognition and the Y maze. For rats, we used the Morris water maze. NAC was administered beginning 30–60 minutes after injury. Behavioral deficits due to injury in both species were significantly reversed by NAC treatment. We thus conclude NAC produces significant behavioral recovery after injury. Future preclinical studies are needed to define the mechanism of action, perhaps leading to more effective therapies in man. PMID:24740427

  14. Efficacy of N-acetyl cysteine in traumatic brain injury.

    Directory of Open Access Journals (Sweden)

    Katharine Eakin

    Full Text Available In this study, using two different injury models in two different species, we found that early post-injury treatment with N-Acetyl Cysteine (NAC reversed the behavioral deficits associated with the TBI. These data suggest generalization of a protocol similar to our recent clinical trial with NAC in blast-induced mTBI in a battlefield setting, to mild concussion from blunt trauma. This study used both weight drop in mice and fluid percussion injury in rats. These were chosen to simulate either mild or moderate traumatic brain injury (TBI. For mice, we used novel object recognition and the Y maze. For rats, we used the Morris water maze. NAC was administered beginning 30-60 minutes after injury. Behavioral deficits due to injury in both species were significantly reversed by NAC treatment. We thus conclude NAC produces significant behavioral recovery after injury. Future preclinical studies are needed to define the mechanism of action, perhaps leading to more effective therapies in man.

  15. Successful Salvage Radiotherapy for a Chemo-refractory, Non-resectable, Undifferentiated Pleomorphic Sarcoma Lung Metastasis with Pericardial Involvement: A Case Report.

    Science.gov (United States)

    Al-Hajri, Thuraya; Chan, Jessica; Caudrelier, Jean-Michel

    2016-01-01

    We report a case of an undifferentiated pleomorphic sarcoma in a 73-year-old female, with a solitary lung metastasis involving the pericardium that progressed on first-line chemotherapy. Partial removal of the lesion was achieved after lingular segmentectomy, which required en-bloc pericardial resection due to deep pericardial invasion. However, the residual disease significantly grew despite second-line chemotherapy, and the tumor became unresectable due to near encasement of the left anterior descending coronary artery. Therefore, we opted for a salvage radical dose of intensity-modulated radiotherapy (60Gy in 25 fractions) to the pericardial lesion. No acute side effects were observed, and after three years of follow-up, good local control has been achieved with no significant late effects observed. This case suggests that radical radiotherapy using IMRT could be considered to treat sarcomatous pericardial lesions in patients who do not respond to chemotherapy and who are inoperable or non-resectable. PMID:26918213

  16. CLINICAL STUDY AND MANAGEMENT OF BLUNT INJURY ABDOMEN PERTAINING TO SOLID ORGANS

    Directory of Open Access Journals (Sweden)

    Katta Srinivasa

    2015-09-01

    Full Text Available Blunt Abdominal trauma is one of the most common causes among injuries caused mainly due to road traffic accidents. 1 The rapid increase in number of motor vehicles and its aftermath has caused rapid increase in number of victims to blunt abdominal trauma. Motor vehicle accidents account for 75 to 80% of blunt abdominal trauma. 2 Blunt injury of abdomen is also a result of fall from height, assault with blunt objects, industrial mishaps, sport injuries, bomb blast and fall from riding bicycle. 2 In view of increasing number of vehicles and consequently road traffic accidents, this topic is chosen to study the cases of blunt abdominal trauma with reference to the patients presenting at Govt. General Hospital, attached to Guntur Medical College, Guntur. OBJECTIVES: The objectives of the study are: 1. To evaluate the impact of blunt abdominal trauma on solid viscera. 2. To evaluate etiology and various modes of presentation. 3. To evaluate various available investigations for the detection of solid organ injuries. 4. To evaluate various modalities of treatment available with aim to reduce the mortality and morbidity. 5. To evaluate common complications of solid organ injury in blunt trauma abdomen. MATERIALS AND METHODS: Patients admitted in Government General Hospital, Guntur, from November 2012 to October 2014 and studied 50 cases. This is a prospective study conducted over 2 years. RESULTS: Male patients were commonly affected (80%, Peak age group being 21 – 30 years (48%. The commonest mode of injury was road traffic accident (58%. The common organ injured was spleen (54% followed by liver. 70% of the patients were treated by surgery, 30% conservatively. The mortality in this study was 14%. CONCLUSIONS : Blunt injury abdomen forms considerable load and health care system, most common age group is youngsters in road traffic accidents , so efforts should be made to formulate and execute road traffic regulations. Well established trauma care

  17. Anterior mediastinal abscess diagnosed in a young sumo wrestler after closed blunt chest trauma.

    Science.gov (United States)

    Sassa, Tatsuro; Kobayashi, Ken-Ichiro; Ota, Masayuki; Washino, Takuya; Hikone, Mayu; Sakamoto, Naoya; Iwabuchi, Sentaro; Otsuji, Mizuto; Ohnishi, Kenji

    2015-12-01

    Most mediastinal abscesses result from infections after thoracotomy, esophageal perforation or pene- trating chest trauma. This disease is rarely caused by closed blunt chest trauma. All previously reported such cases after closed blunt chest trauma presented with hematoma and sternal osteomyelitis resulting from sternal fracture. Here we report a 15-year-old sumo wrestler who presented with an anterior mediastinal abscess without any mediastinal fracture. The mediastinal abscess resulted from the hematogenous spread of Staphylococcus aureus to a hematoma that might have been caused by a closed blunt chest trauma incurred during sumo wrestling exercises. PMID:26917029

  18. Surgical Management of Undiagnosed Laceration of Superior Vena Cava Caused by Blunt Trauma.

    Science.gov (United States)

    Bouabdallaoui, Nadia; Debbagh, Hassan; Schoell, Thibaut; Lebreton, Guillaume

    2016-05-01

    Intrapericardial rupture of the superior vena cava resulting from blunt thoracic trauma is a rare and life-threatening condition that has to be ruled out in the presence of signs of cardiac tamponade and a history of blunt thoracic trauma. We report the case of undiagnosed superior vena cava laceration caused by a high-speed road traffic accident in a 25 year-old patient revealed by cardiac tamponade. We highlight the need of urgent surgical exploration in all patients whose condition is unstable in the setting of blunt thoracic trauma regardless of imaging conclusions. PMID:27106431

  19. Compressibility and Leading-Edge Bluntness Effects for a 65 Deg Delta Wing

    Science.gov (United States)

    Luckring, J. M.

    2004-01-01

    A 65 deg. delta wing has been tested in the National Transonic Facility (NTF) at mean aerodynamic chord Reynolds numbers from 6 million to 120 million at subsonic and transonic speeds. The configuration incorporated a systematic variation of the leading edge bluntness. The analysis for this paper is focused on the compressibility and bluntness effects primarily at a Reynolds number of 6 million from this data set. Emphasis is placed upon on the onset and progression of leading-edge vortex separation, and compressibility is shown to promote this separation. Comparisons with recent publications show that compressibility and Reynolds number have opposite effects on blunt leading edge vortex separation

  20. Working toward exposure thresholds for blast-induced traumatic brain injury: thoracic and acceleration mechanisms

    CERN Document Server

    Courtney, Michael; 10.1016/j.neuroimage.2010.05.025

    2011-01-01

    Research in blast-induced lung injury resulted in exposure thresholds that are useful in understanding and protecting humans from such injury. Because traumatic brain injury (TBI) due to blast exposure has become a prominent medical and military problem, similar thresholds should be identified that can put available research results in context and guide future research toward protecting warfighters as well as diagnosis and treatment. At least three mechanical mechanisms by which the blast wave may result in brain injury have been proposed - a thoracic mechanism, head acceleration and direct cranial transmission. These mechanisms need not be mutually exclusive. In this study, likely regions of interest for the first two mechanisms based on blast characteristics (positive pulse duration and peak effective overpressure) are developed using available data from blast experiments and related studies, including behind-armor blunt trauma and ballistic pressure wave studies. These related studies are appropriate to in...

  1. Hepatic pseudoaneurysm after traumatic liver injury; is CT follow-up warranted?

    DEFF Research Database (Denmark)

    Østerballe, Lene; Helgstrand, Frederik; Axelsen, Thomas; Hillingsø, Jens; Svendsen, Lars Bo

    2014-01-01

    INTRODUCTION: Hepatic pseudoaneurysm (HPA) is a rare complication after liver trauma, yet it is potentially fatal, as it can lead to sudden severe haemorrhage. The risk of developing posttraumatic HPA is one of the arguments for performing follow-up CT of patients with liver injuries. The aim of...... this study was to investigate the occurrence of HPA post liver trauma. METHODS: A retrospective study from 2000-2010 of conservatively treated patients with blunt liver trauma was performed to investigate the incidence and nature of HPA. After the initial CT scan patients were admitted to the...... study shows that HPA is not correlated to the severity of liver injury and it develops in 4% of patients after traumatic liver injury. In order to avoid potentially life-threatening haemorrhage from a post trauma hepatic pseudoaneurysm, it seems appropriate to do follow-up CT as part of the conservative...

  2. Incorporating Human Body Mass in Standards of Helmet Impact Protection against Traumatic Brain Injury

    CERN Document Server

    Blackman, Eric G

    2009-01-01

    Impact induced traumatic brain injury (ITBI) describes brain injury from head impact not necessarily accompanied by skull fracture. For sufficiently abrupt head impact decelerations, ITBI results from brain tissue stress incurred as the brain crashes into the inside of the skull wall, displacing the surrounding cerebral spinal fluid (CSF). Proper helmet cushioning can damp the impact force and reduce ITBI. But force is mass times acceleration and commonly used helmet blunt impact standards are based only on acceleration thresholds. Here I show how this implies that present standards overestimate the minimum acceleration onset for ITBI by implicitly assuming that the brain is mechanically decoupled from the body. I quantify how an arbitrary orientation of the body with respect to impact direction increases the effective mass that should be used in calculating the required damping force and injury threshold accelerations. I suggest a practical method to incorporate the body mass and impact angle into ITBI helme...

  3. Transpupillary Argon Laser Cyclophotocoagulation in a Refractory Traumatic Glaucoma Patient with Aphakia and Aniridia

    Directory of Open Access Journals (Sweden)

    Umut Duygu Uzunel

    2016-01-01

    Full Text Available We present a case of transpupillary argon laser cyclophotocoagulation (TALC in a patient with traumatic aniridia and aphakia secondary to blunt trauma who had previous bilateral trabeculectomy. Four months after the trauma the patient’s intraocular pressure (IOP rose to 35 mmHg despite topical antiglaucomatous medication. Inferior 180 degrees cyclophotocoagulation was performed with transpupillary argon laser in the first session and his IOP fell to values of 12-17 mmHg. Twelve weeks after TALC, his IOP rose to 22 mmHg and we had to apply TALC to the residual ciliary processes. Seven months later his IOP was 13 mmHg with topical dorzolamide/timolol and latanoprost administration. TALC may be an effective treatment alternative for lowering IOP in patients with visible ciliary processes who do not respond to conventional medical or laser treatment.

  4. Combination of traumatic thoracic aortic pseudoaneurysm and myocardial contusion leading to left ventricular aneurysm

    International Nuclear Information System (INIS)

    The combination of thoracic aortic pseudoaneurysm and left ventricular aneurysm resulting from a single traumatic incident is an exceedingly rare occurrence. We present a case of a 10-year-old girl who sustained significant blunt trauma to the chest after being involved in a rollover motor vehicle accident. The child underwent immediate repair of a transected aortic arch. An inferior wall left ventricular aneurysm developed 3 weeks later, and the patient underwent successful repair of the left ventricular aneurysm and a damaged mitral valve. The use of fast multidetector row CT, cardiac MRI, and echocardiography have improved our ability to diagnose these types of injuries and accurately image their anatomic relationships in the acute and perioperative settings. (orig.)

  5. Prevalence of 'high-riding' superior pericardial recesses on thin-section 16-MDCT scans

    Energy Technology Data Exchange (ETDEWEB)

    Basile, Antonio [Department of Radiology and Interventional Radiology, Ospedale Ferrarotto, via Citelli, 8 95124 Catania (Italy)]. E-mail: antodoc@yahoo.com; Bisceglie, Paola [Department of Radiology and Interventional Radiology, Ospedale Ferrarotto, via Citelli, 8 95124 Catania (Italy); Giulietti, Giorgio [Department of Radiology and Interventional Radiology, Ospedale Ferrarotto, via Citelli, 8 95124 Catania (Italy); Calcara, Giacomo [Department of Radiology and Interventional Radiology, Ospedale Ferrarotto, via Citelli, 8 95124 Catania (Italy); Figuera, Michele [Department of Radiology, Ospedale Vittorio Emanuele, Via Plebiscito 628, 95124 Catania (Italy); Mundo, Elena [Department of Radiology and Interventional Radiology, Ospedale Ferrarotto, via Citelli, 8 95124 Catania (Italy); Granata, Antonio [Department of Nephrology, Ospedale Vittorio Emanuele, Via Plebiscito 628, 95124 Catania (Italy); Runza, Giuseppe [Department of Radiology, Policlinico Universitario, Via del Vespro 129, 90127 Palermo (Italy); Privitera, Carmelo [Department of Radiology, Ospedale Vittorio Emanuele, Via Plebiscito 628, 95124 Catania (Italy); Privitera, Giambattista [Department of Radiology and Interventional Radiology, Ospedale Ferrarotto, via Citelli, 8 95124 Catania (Italy); Patti, Maria Teresa [Department of Radiology and Interventional Radiology, Ospedale Ferrarotto, via Citelli, 8 95124 Catania (Italy)

    2006-08-15

    Objective: The aim of this study was to evaluate the prevalence of 'high-riding' superior pericardial recess (HRSPR) on thin-section (1 mm) 16-multidetector computed tomography (MDCT) scans. Materials and methods: Three hundred and fourteen consecutive chest CT scans obtained with a thin-section 16 MDCT were retrospectively evaluated. The prevalence and characteristic of HRSPR were analyzed. Results: HRSPR was depicted in 21 patients (11 men and 10 women) (6.6%) who ranged in age from 28 to 72 years (mean age, 57 years). The extended recesses were rounded/oval shaped in five patients and triangular, spindle, half moon or irregular shaped in the other 16 patients. Conclusion: Our data suggest as HRSPRs are more frequently and better depicted on thinsection MDCT scans, and this improves the capability to distinguish this superior extension of the superior aortic recess from abnormal findings such as lymphadenopathy, cystic lesions, and aortic dissection.

  6. Blunted cardiac stress reactors exhibit relatively high levels of behavioural impulsivity.

    Science.gov (United States)

    Bibbey, Adam; Ginty, Annie T; Brindle, Ryan C; Phillips, Anna C; Carroll, Douglas

    2016-05-15

    Blunted physiological reactions to acute psychological stress are associated with a range of adverse health and behavioural outcomes. This study examined whether extreme stress reactors differ in their behavioural impulsivity. Individuals showing blunted (N=23) and exaggerated (N=23) cardiovascular reactions to stress were selected by screening a healthy student population (N=276). Behavioural impulsivity was measured via inhibitory control and motor impulsivity tasks. Blunted reactors exhibited greater impulsivity than exaggerated reactors on both stop-signal, F(1,41)=4.99, p=0.03, ηp(2)=0.108, and circle drawing, F(1,43)=4.00, p=0.05, η p(2)=0.085, tasks. Individuals showing blunted cardiovascular stress reactions are characterized by greater impulsivity which may contribute to their increased susceptibility to outcomes such as obesity and addiction. PMID:26988282

  7. External air compression: A rare cause of blunt esophageal injury, managed by a stent

    Directory of Open Access Journals (Sweden)

    Mohammed Muneer

    2014-01-01

    CONCLUSION: High index of suspicion is needed for early diagnosis of esophageal perforation after blunt trauma. Appropriate drainage, antibiotic and temporary endoscopic esophageal stenting may be an optimal approach in selected patients, especially with delayed diagnosis.

  8. Crack tip blunting in ductile material under mixed mode loading by the slip line theory

    International Nuclear Information System (INIS)

    Crack tip blunting in ductile material was analyzed under a small-scale yielding subject to mixed mode loadings of Mode I and Mode II. The material was assumed to be an elastic perfectly-plastic solid with Poisson's ratio being 1/2. The slip line field for a sharp crack under mixed mode loading was first determined by means of elastic-plastic finite element analysis. It was shown that only one elastic sector exists in the vicinity of the crack tip differing from the possibility of the existence of two elastic sectors discussed by Gao. The result for the sharp crack obtained was used as the boundary condition for the analysis of crack tip blunting. The characteristic shape of the crack tip blunting was obtained, which is just like the tip of a Japanese sword. Also, the stress field was determined around the blunted crack tip. (author)

  9. Hepatic arterial pseudoaneurysm: a rare complication of blunt abdominal trauma in children

    International Nuclear Information System (INIS)

    We report a child who developed a hepatic artery pseudoaneurysm following blunt hepatic injury. This is a rare complication of hepatic trauma in children. The imaging evaluation and clinical management of hepatic artery pseudoaneurysms are presented. (orig.)

  10. Arch vessel injury: geometrical considerations. Implications for the mechanism of traumatic myocardial infarction II

    Directory of Open Access Journals (Sweden)

    Ismailov Rovshan M

    2006-09-01

    Full Text Available Abstract Background Various types of vascular injury have been reported in the medical literature; the isthmic part of the aorta is at particularly high risk of traumatic rupture. Early diagnosis results in better survival, justifying the search for potential risk factors and diagnostic tests. The aim of this research was to investigate the complex mechanism of blunt injury to the vascular wall with particular focus on the branching region of the vessels. Geometric peculiarities were investigated. Methods Multi-phase equations have been used. The system of equations with certain boundary conditions was solved numerically by applying the finite-difference method with order of approximation equal to 0.0001. Results The degree of curvature (the Dean number is highly informative about the shear stress on the external surface of the vessel. An important function of the blood flow on the external wall is to destroy rouleaux. The viscosity of phase 2 (f2 exceeds, by many times, the viscosity of phase 1 (f1. The major stress created by blood flow is expressed as the shear stress of f2. The volume fraction of rouleaux depends to a greater degree on the concentration of erythrocytes (expressed as the viscosity of the mixture than on the shear stress. The peculiarities of rouleaux formation were assessed and their impact on the local shear stress and, therefore, on the internal wall was determined in relation to the erythrocyte concentration. Conclusion The results of this research take into account certain geometrical peculiarities of the branching part of the vessel. The mathematical model created in this study will improve our understanding of the complex mechanism of blunt injury to the vascular wall and, therefore, conditions such as aortic rupture and traumatic acute myocardial infarction.

  11. Traumatic lung lesions: computed tomography findings; Lesoes traumaticas do parenquima pulmonar: aspectos na tomografia computadorizada

    Energy Technology Data Exchange (ETDEWEB)

    Melo, Alessandro Severo Alves de; Moreira, Luiza Beatriz Melo [Hospital Municipal Souza Aguiar, Rio de Janeiro, RJ (Brazil); Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Disciplina de Radiologia

    2003-06-01

    Traumatic lesions of the lung are common findings in patients with thoracic trauma. These lesions are increasingly diagnosed using computed tomography, mostly due to the fast acquisition time helical techniques that allow evaluation of critically ill patients and an efficient therapeutic management. The authors studied 150 patients with thoracic trauma submitted to computed tomography that demonstrated lung contusions, atelectasis, lacerations and hematomas. Lung contusions were the most frequent lesions appearing as consolidation or ground-glass attenuation areas. Atelectasis, in subsegmentar and compressive patterns, were the second most common lesions observed. Lacerations appeared as consolidations with air or liquid level. Lung hematomas, characterized by round opacities, were the most rare lung lesions seen in only five cases. In this study, blunt thoracic trauma accounted for the majority of 120 cases whereas penetrating trauma occurred in 30 cases. The causes of blunt trauma in de crescent order of frequency were motor vehicle accidents, pedestrian hit by car, falls, motorcycle accidents and trashing. Penetrating traumas were caused by bullets or knives. (author)

  12. Traumatic mediastinal lesions: computed tomography findings; Lesoes traumaticas do mediastino: aspectos na tomografia computadorizada

    Energy Technology Data Exchange (ETDEWEB)

    Melo, Alessandro Severo Alves de; Moreira, Luiza Beatriz Melo [Hospital Municipal Souza Aguiar, Rio de Janeiro, RJ (Brazil); Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Disciplina de Radiologia]. E-mail: Lubiamoreira@bol.com.br

    2003-10-01

    Traumatic mediastinal lesions are unusual findings in patients with thoracic trauma but may represent poor prognosis and be associated with severe lesions. Mediastinal trauma is increasingly being diagnosed by computed tomography due to the fast acquisition times of helical techniques, allowing the evaluating of critically ill patients and the adoption of efficient therapeutic measures. The authors studied 11 patients with mediastinal lesions who were submitted to computed tomography due to thoracic trauma. The most frequent finding was mediastinal bleeding characterized by infiltration of mediastinal fat, dense material within the mediastinal spaces or hematoma. Hemo pericardium was the second most common lesion in this series, appearing as dense or liquid material in the pericardium. Aortic lesions such as wall irregularities or pseudoaneurisms were less commonly seen (three patients). In this study blunt thoracic traumas were observed in six cases whereas penetrating trauma occurred in five cases. The causes of blunt trauma were pedestrians struck by car, motor vehicle accidents and falls. Penetrating trauma was due to lesions produced by bullets or knifes. (author)

  13. Traumatic Pseudo-Aneurysm and Concurrent Dissection of the Aortic Arch Treated with Endovascular Stenting

    Directory of Open Access Journals (Sweden)

    H. Ghanaati

    2010-12-01

    Full Text Available The pseudo-aneurysms of thoracic aorta are rare and a life-threatening complication of aortic"nsurgery and blunt chest trauma. This article demonstrates a case report of a traumatic aortic"narch dissection and formation of a false aneurysm after blunt chest trauma in Iran. A 23-year-old"nman was referred complaining of chest pain and exertional cough. He had a history of chest and"nabdominal trauma five months ago after a car accident, resulting in acceleration-deceleration"ninjury. The trauma resulted in an extensive injury on the left side of the chest and abdomen"nassociated with multiple rib fractures, hemopneumothorax and splenic rupture. Splenectomy"nand left chest tube drainage was performed. The patient was admitted for 15 days. Finally, he"nrecovered to normal and was discharged in satisfactory condition. However, his chest pain and"ncough restarted and its severity gradually increased. In chest x-ray, a left upper mediastinal mass"nwas detected, which was later confirmed by 64 multi-slice chest CT scan as a false aortic arch"naneurysm and aortic dissection. It seems endovascular stent-graft technique for the treatment of"nthoracic aorta aneurysm may present a good treatment choice with a low risk and less invasive"napproach.

  14. Perihepatic Packing versus Primary Surgical Repair in Patients with Blunt Liver Trauma; an 8-year Experience

    OpenAIRE

    Shahram Paydar; Mojtaba Mahmoodi; Mohammad(behdad) Jamshidi; Hadi Niakan; Mohammad Keshavarz; Nader Moeenvaziri; Mohammad Esmaeil Ghorbaninejad; Farnaz Farrokhnia; Forough Izadi Fard; Zahra Jaafari; Yalda Golshan; Hamidreza Abbasi; Shahram Bolandparvaz; Behnam Honarvar

    2014-01-01

    Objective: To explore the pros and cons of early versus delayed intervention when dealing with severe blunt liver injury with significant hemoperitoneum and hemodynamic instability. Methods: This retrospective cross-sectional study was performed at the Nemazi hospital, Shiraz, Southern Iran, level I trauma Center affiliated with Shiraz University of Medical Sciences. The study population comprised of all patients who were operated with the impression of blunt abdominal trauma and confir...

  15. Stimulant-induced dopamine increases are markedly blunted in active cocaine abusers

    OpenAIRE

    Volkow, ND; Tomasi, D.; Wang, G-J; J. Logan; Alexoff, DL; Jayne, M; Fowler, JS; C Wong; P. Yin; Du, C.

    2014-01-01

    Dopamine signaling in nucleus accumbens is essential for cocaine reward. Interestingly, imaging studies have reported blunted dopamine increases in striatum (assessed as reduced binding of [11C]raclopride to D2/D3 receptors) in detoxified cocaine abusers. Here, we evaluate whether the blunted dopamine response reflected the effects of detoxification and the lack of cocaine-cues during stimulant exposure. For this purpose we studied 62 participants (43 non-detoxified cocaine abusers and 19 con...

  16. Blunt trauma of the heart: CT pattern of atrial appendage ruptures

    International Nuclear Information System (INIS)

    Blunt trauma patients with myocardial ruptures rarely survive long enough to reach a trauma center; however, for the survivors, prompt diagnosis and surgery are mandatory and save up to 80% of patients. Preoperative diagnosis of myocardial ruptures is assessed by echocardiography or, more rarely, by echocardiography. We report two cases of blunt trauma patients with an atrial appendage rupture which could be retrospectively identified on admission CT survey. (orig.)

  17. Ocular blunt trauma: loss of sight from an ice hockey injury

    OpenAIRE

    Morris, Daniel S.

    2009-01-01

    A case of ocular blunt trauma is described in which a 17 year old male ice hockey player collided with an opponent during a game. The opponent's stick travelled under the patient's half face visor and struck his left eye causing hyphema, angle recession, lens subluxation, and choroidal rupture over the macula, permanently reducing his vision to counting fingers. Sequelae of ocular blunt trauma are discussed along with methods of injury prevention by addressing players' behaviour and safety eq...

  18. Open Surgical Bypass for Superficial Femoral Artery Occlusion Caused by Blunt Trauma

    OpenAIRE

    Ikeda, Akihiko; Kudo, Yohei; Maeda, Michihiro; Tochiki, Aito; Ichimura, Haruto; Uesugi, Masafumi; Jikuya, Tomoaki

    2015-01-01

    Blunt vascular trauma of the lower extremities brings about a high amputation rate, because other organ injuries disturb revascularization. We experienced a case of a superficial femoral artery occlusion caused by blunt trauma. The patient also had a femoral bone fracture and a large skin defect with deep muscular injuries of the thigh. We performed a femoropopliteal (FP) bypass using a saphenous vein which was routed through the contaminated wound. Postoperative vacuum-assisted closure thera...

  19. Testicular Infarction and Rupture After Blunt Trauma — Use of Diagnostic Ultrasound

    Directory of Open Access Journals (Sweden)

    Alistair Pace

    2004-01-01

    Full Text Available We report the case of a 23-year-old male who suffered localised testicular infarction and rupture following blunt trauma. This pathology is rare after blunt trauma and has not been previously described in literature. The appearance on ultrasound resembled malignancy, necessitating orchidectomy. An overview of the pathology of testicular trauma as well as its management is given with particular emphasis on the use diagnostic ultrasound in testicular trauma.

  20. The Houdini effect--an unusual case of blunt abdominal trauma resulting in perforative appendicitis.

    LENUS (Irish Health Repository)

    O'Kelly, F

    2012-03-01

    We present a unique case of perforative appendicitis that occurred in an adult following blunt abdominal trauma. This case represents the first such reported case from Ireland. It also represents a modern practical example of Laplace\\'s theory of the effect of increased pressure on colonic wall tension leading to localized perforation, and serves to highlight not only the importance in preoperative imaging for blunt abdominal trauma, but also the importance of considering appendiceal perforation.

  1. Is there any role for resuscitative emergency department thoracotomy in blunt trauma?

    OpenAIRE

    Khorsandi, Maziar; Skouras, Christos; Shah, Rajesh

    2012-01-01

    A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was whether there is any role for resuscitative emergency department thoracotomy in severe blunt trauma. Emergency thoracotomy is an accepted intervention for patients with penetrating cardiothoracic trauma. However, its role in blunt trauma has been challenged and has been a subject of considerable debate. Altogether, 186 relevant papers were identified, of which 14 represen...

  2. Massive hemothorax due to inferior phrenic artery injury after blunt trauma

    OpenAIRE

    Aoki, Makoto; Shibuya, Kei; Kaneko, Minoru; Koizumi, Ayana; Murata, Masato; Nakajima, Jun; Hagiwara, Shuichi; Kanbe, Masahiko; Koyama, Yoshinori; Tsushima, Yoshito; Oshima, Kiyohiro

    2015-01-01

    Injury to the inferior phrenic artery after blunt trauma is an extremely rare event, and it may occur under unanticipated conditions. This case report describes an injury to the left inferior phrenic artery caused by blunt trauma, which was complicated by massive hemothorax, and treated with transcatheter arterial embolization (TAE). An 81 year-old female hit by a car while walking at the traffic intersection was transferred to the emergency department, computed tomography scanning revealed a...

  3. Pseudopancreatitis on computed tomography in a patient with isolated blunt head trauma: a case report

    OpenAIRE

    Cheng, Ah-Ling; Lang, Eddy S

    2014-01-01

    Introduction Computed tomography is commonly used to exclude occult injuries in patients with trauma, but imaging can reveal findings that are of uncertain etiology or clinical significance. We present a case of unsuspected pancreatic abnormality in a female patient with trauma who sustained an isolated blunt head injury. Case presentation A 25-year-old female Caucasian patient sustained massive blunt and penetrating head trauma, secondary to a large object penetrating through the vehicle win...

  4. Blunt Cardiac Injury in Trauma Patients with Thoracic Aortic Injury

    Directory of Open Access Journals (Sweden)

    Rathachai Kaewlai

    2011-01-01

    Full Text Available Trauma patients with thoracic aortic injury (TAI suffer blunt cardiac injury (BCI at variable frequencies. This investigation aimed to determine the frequency of BCI in trauma patients with TAI and compare with those without TAI. All trauma patients with TAI who had admission electrocardiography (ECG and serum creatine kinase-MB (CK-MB from January 1999 to May 2009 were included as a study group at a level I trauma center. BCI was diagnosed if there was a positive ECG with either an elevated CK-MB or abnormal echocardiography. There were 26 patients (19 men, mean age 45.1 years, mean ISS 34.4 in the study group; 20 had evidence of BCI. Of 52 patients in the control group (38 men, mean age 46.9 years, mean ISS 38.7, eighteen had evidence of BCI. There was a significantly higher rate of BCI in trauma patients with TAI versus those without TAI (77% versus 35%, P<0.001.

  5. Laser differential interferometry for supersonic blunt body receptivity experiments

    Science.gov (United States)

    Salyer, Terry Ray

    2002-01-01

    The laser differential interferometer is a high sensitivity (lambda/13,000 minimum detectable wavelength shift), large bandwidth (6 MHz), nonintrusive instrument ideal for low-density optical flow diagnostics. Up to one half wavelength shifts are possible with active phase compensation. With feedback control, a phase modulator stabilizes the system within the linear range. Calibrated receptivity experiments are performed in a Mach 4 quiet-flow Ludwieg tube. Laser-generated thermal spots are used as repeatable, controlled perturbations to the subsonic region behind the bow shock of both a hemispherical nose and a forward-facing cavity. Thermal spot amplitudes, spatial characteristics, and repeatability are measured. Both on-axis and off axis surveys of the subsonic region indicate damped oscillations with both blunt nose configurations. With the forward-facing cavity, a characteristic frequency based on the cavity geometry is detected. The results from both configurations correlate with nose-mounted and cavity base-mounted pressure transducer measurements, and thus remove frequency ambiguity from the pressure transducer experiments. High speed synchronous schlieren images show the thermal spot evolution and impingement at the hemispherical nose. Additionally, the thermal spot in freestream is modeled based on the experimental measurements. Quantitative comparisons with CFD simulations of these experiments show similar characteristics. CFD agreement is expected to improve with future use of the advanced thermal spot model.

  6. Blunt-body drag reduction through base cavity shape optimization

    Science.gov (United States)

    Lorite-Díez, Manuel; Jiménez-González, José Ignacio; Gutiérrez-Montes, Cándido; Martínez-Bazán, Carlos

    2015-11-01

    We present a numerical study on the drag reduction of a turbulent incompressible flow around two different blunt bodies, of height H and length L, at a Reynolds number Re = ρU∞ H / μ = 2000 , where U∞ is the turbulent incompressible free-stream velocity, ρ is their density and μ their viscosity. The study is based on the optimization of the geometry of a cavity placed at the rear part of the body with the aim of increasing the base pressure. Thus, we have used an optimization algorithm, which implements the adjoint method, to compute the two-dimensional incompressible turbulent steady flow sensitivity field of axial forces on both bodies, and consequently modify the shape of the cavity to reduce the induced drag force. In addition, we have performed three dimensional numerical simulations using an IDDES model in order to analyze the drag reduction effect of the optimized cavities at higher Reynolds numbers.The results show average drag reductions of 17 and 25 % for Re=2000, as well as more regularized and less chaotic wake flows in both bodies. Supported by the Spanish MINECO, Junta de Andalucía and EU Funds under projects DPI2014-59292-C3-3-P and P11-TEP7495.

  7. CT diagnosis of intraperitoneal bladder rupture with blunt abdominal trauma

    International Nuclear Information System (INIS)

    Objective: To evaluate CT examination in the diagnosis of intraperitoneal bladder rupture (IPBR) caused by blunt abdominal trauma. Methods: All CT and clinical data of 9 patients with IPBR were reviewed retrospectively. Results: IPBR was detected on CT scans in all 9 patients. CT findings of IPBR included low -attenuation free intraperitoneal fluid collections in the lateral paravesical fossae, the pericolic space, the culde-sac of the pelvis, Morison's pouch, the peri-hepatic space, the perisplenic space and interspace of bowel loops in 9 cases with a lower CT density compared with pure blood. The disruption of the bladder wall was located by CT scan in 5 cases: high-attenuation bladder wall with focal defect in 3 cases and a tear drop-like deformity of the bladder in 2 cases. Other CT findings supporting the diagnosis of IPBR included an underfilled bladder in 8 cases, bladder contusion in 4 cases, and blood clots within the bladder in 6 cases. Conclusion: The presence of intraperitoneal fluid with a CT density less than that of pure blood strongly suggests extravasated urine in the trauma. Intraperitoneal and extraperitoneal rupture can be distinguished based on location of extravasated urine seen on CT scans. The precise localization of the ruptured bladder wall may be demonstrated by CT scan, which is valuable for surgical treatment

  8. Imaging gastrointestinal perforation in pediatric blunt abdominal trauma

    International Nuclear Information System (INIS)

    Objective. To assess the role of imaging, in particular CT, in the early detection of GI perforation. Subjects and methods. In a 10-year period, 43 patients with surgically confirmed GI perforation were identified from hospital records; 22 of these had preoperative CT evaluation. Medical records and radiology were retrospectively reviewed and CT studies were particularly assessed for extraluminal air, free intraperitoneal fluid, bowel wall thickening, bowel wall enhancement, and bowel dilatation. During the study period an additional 12 trauma patients were identified who had CT studies demonstrating the above findings, but who had hypovolemic shock bowel or nondisrupting bowel injury without perforation evident. Results. Extraluminal air was demonstrated in 47 % of the imaged perforations. There was one false-positive extraluminal air. Perforation was confirmed in patients who had all five of the above CT findings, but this was the case for only 18 % of patients with perforation. One or more of the five specified CT findings were present in all CT studies reviewed. No false-negative CT study was performed in the study period. Conclusion. Separating nondisrupting bowel injury from perforation is diagnostically difficult; however, CT remains a good modality for assessing GI perforation in pediatric blunt trauma, but it cannot replace diligent and repeated clinical evaluation of all potential perforation victims. (orig.). With 4 figs., 1 tab

  9. Emergency CT in blunt abdominal trauma of multiple injury patients

    International Nuclear Information System (INIS)

    Multiple injury patients with blunt abdominal trauma (n = 110) were examined by abdominal CT. An i.v., but not peroral, contrast medium was used, thereby eliminating the delay caused by administering peroral contrast medium and any subsequent delay in making the diagnoses and beginning operative treatment. Eighteen patients underwent emergency laparotomy after the initial CT examination. The preoperative CT findings were compared to the laparotomy findings. CT revealed all but one of the severe parenchymal organ lesions requiring surgery. The one liver laceration that went undetected had caused hemoperitoneum, which was diagnosed by CT. The bowel and mesenteric lesions presented as intra-abdominal blood, and the hemoperitoneum was discovered in every patient with these lesions. Fourteen patients also initially had positive abdominal CT findings; 10 of them underwent an additional abdominal CT within 3 days, but the repeat studies did not reveal any lesions in need of surgery. Omission of the oral contrast medium did not jeopardize making the essential diagnoses, but it did save time. (orig.)

  10. Study of Duodenal Rupture Followed by Abdominal Blunt Trauma

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Abdoulhosseini

    2014-01-01

    Full Text Available Duodenal rupture followed by blunt trauma is usually very rare and happens by hit to epigastrium region caused by trauma, accident or sport injuries. Because of unclear signs or no specific signs of rupture, usually diagnosis of rupture is delayed and associated with dangerous or occasionally deathful complications. The patient was a 29-year-old male who three days after accident referred to emergency unit of Shahroud Imam Hossein hospital with severe pain of abdomen, nausea, decrease in level of consciousness and unstable vital signs. After resuscitation, the patient with diagnosis of peritonitis underwent laparotomy. He had transverse and severs rupture that after duodenal reconstruction, a jejunostomy was performed, then a drain was placed at the site of duodenum and pancreas and the patient was sent to ICU. After two days followed by leakage from abdominal drain, the patient underwent laparotomy again. Then after one week, followed by leakage from abdominal drain, the patient underwent laparotomy. One week after last operation, due to general condition improvement, the patient was transferred to surgical ward and jejunostomy feeding was started for him and duodenostomy and jejunostomy were excluded. Then with enough speed, and paying attention to clinical signs & symptoms and with patient's exact examination, it is possible to prevent the waste of time and expense and gain desired results of treatment.

  11. Blunting post-meal glucose surges in people with diabetes.

    Science.gov (United States)

    Chacko, Elsamma

    2016-06-10

    Worldwide, the morbidity and mortality associated with non-communicable diseases have been climbing steadily - with costs aggressively keeping pace. This letter highlights a decidedly low-cost way to address the challenges posed by diabetes. High levels of postprandial blood glucose are disproportionately linked to much of the microvascular damage which, in the end, leads to macrovascular complications and organ failures. Systematically controlling post-meal glucose surges is a critical element of overall glycemic management in diabetes. Diet, exercise and medications form a triad of variables that individuals engaged in diabetes self-management may manipulate to achieve their targeted glucose levels. As a rule, diabetes patients in developing countries as well as those living in the pockets of poverty in the western world cannot afford special diets, medications, glucometers and supplies, lab tests and office visits. Exercise is the one option that is readily accessible to all. Decades of research in laboratory settings, viewed holistically, have established that light to moderate aerobic exercise for up to 60 min starting 30 min after the first bite into a meal can blunt the ensuing glucose surge effectively. Moderate resistance exercise, moderate endurance exercise or a combination of the two, practiced post-meal has also been found to improve many cardio-metabolic markers: Glucose, high density lipoprotein, triglycerides, and markers of oxidative stress. On the other hand, pre-breakfast exercise and high-intensity exercise in general have been decidedly counterproductive. PMID:27326346

  12. Traumatic lumbar spinal subdural hematoma

    OpenAIRE

    Gordon, William E.; Brent Y. Kimball; Arthur, Adam S

    2014-01-01

    Spinal subdural hematoma (SDH) is a rare and potentially life-threatening condition associated with trauma, lumbar puncture, hemorrhagic disorder, anticoagulant therapy, spinal surgery, tumor, vascular malformations, and spinal or epidural anesthesia. Traumatic SDH is even more uncommon than other forms of SDH with only 10 reported cases in the literature. Following a punch to the head and loss of consciousness, a 35-year-old man reported headaches, right-sided tinnitus, and dull ache behi...

  13. Relations among traumatic subdural lesions.

    OpenAIRE

    Lee, K. S.; Doh, J. W.; Bae, H. G.; Yun, I. G.

    1996-01-01

    Acute subdural hematoma (ASDH), chronic subdural hematoma (CSDH) and subdural hygroma (SDG) occur in the subdural space, usually after trauma. We tried to find a certain relationship among these three traumatic subdural lesions in 436 consecutive patients. We included all subdural lesions regardless of whether they were main or not. We evaluated the distribution, age incidence and interval from injury to diagnosis of these lesions, and the frequency of new subdural lesions in each lesion. ASD...

  14. Traumatic hip dislocations in children

    International Nuclear Information System (INIS)

    Objectives: To evaluate clinical features, treatment and relationship to the time period between dislocation, reduction and early complications of traumatic dislocation of hip in children. Methods: Case series conducted at Jinnah Post Graduate Medical Centre Karachi from July 2005 to August 2009. Children with traumatic hip dislocation up to fifteen years of age who presented in last four years were included in this study. Their clinical information, etiology, associated injuries, duration, method of reduction and early complications are evaluated through emergency room proforma and indoor record. Follow up of patient was updated in outpatient department. Results: We had eight patients, six boys and two girls. Youngest 2.4 years and eldest was 12 years with mean age of 6.2 +- 3.8 years. All presented with posterior hip dislocation. Etiology was road traffic accident in two and history of fall in remaining six patients. Average duration of time between dislocation and reduction was 19 hours range 3-72 hours. Dislocated hips were reduced under General Anaesthesia in two patients and under sedation analgesia in six patients. No complications were noted in eight cases with mean 18.75 +- 13.23 months follows up. Conclusion: Traumatic hip dislocation in children is not rare. Slight trauma causes dislocation in younger age and immediate closed reduction and Immobilization reduces complications. (author

  15. [Post-traumatic stress disorder after childbirth].

    Science.gov (United States)

    Korábová, I; Masopustová, Z

    2016-01-01

    The aim of this paper is to introduce the issue of post-traumatic stress disorder after childbirth to health care professionals. The text focuses on the diagnostic definition of post-traumatic stress disorder after childbirth, symptoms, physiological background, prevalence, course, risk factors and consequences of post-traumatic stress disorder after childbirth for a woman, her child and her partner. Options for interventions and therapy are outlined as well. PMID:26982058

  16. Traumatic stress: effects on the brain

    OpenAIRE

    Bremner, J Douglas

    2006-01-01

    Brain areas implicated in the stress response include the amygdala, hippocampus, and prefrontal cortex. Traumatic stress can be associated with lasting changes in these brain areas. Traumatic stress is associated with increased cortisol and norepinephrine responses to subsequent stressors. Antidepressants have effets on the hippocampus that counteract the effects of stress. Findings from animal studies have been extended to patients with post-traumatic stress disorder (PTSD) showing smaller h...

  17. An audit of traumatic nerve injury.

    LENUS (Irish Health Repository)

    O'Connor, G

    2009-07-01

    The impact of trauma in the Irish healthcare setting is considerable. We present the results of a retrospective assessment of referrals to a Neurophysiology department for suspected traumatic nerve injury. A broad range of traumatic neuropathies was demonstrated on testing, from numerous causes. We demonstrate an increased liklihood of traumatic nerve injury after fracture \\/ dislocation (p = 0.007). Our series demonstrates the need for clinicians to be aware of the possibility of nerve injury post trauma, especially after bony injury.

  18. Medico-legal implications of traumatic cataract.

    Science.gov (United States)

    Moreschi, Carlo; Da Broi, Ugo; Lanzetta, Paolo

    2013-02-01

    Traumatic cataract is due to lens damage when mechanical, irradiative, electrical or chemical agents injury the globe. The appearance of a traumatic cataract is typically short and unilateral with rare spontaneous resolution and often involves other ocular anatomical areas. Medico-legal evaluation of the appearance and the consequences of a traumatic cataract requires a correct methodological approach with the support of qualified ophthalmological competences. PMID:23357390

  19. Abuse, Post-Traumatic Stress Disorder and Migraine

    Science.gov (United States)

    ... Post Traumatic Stress Disorder and Migraine Print Email Abuse, Post Traumatic Stress Disorder and Migraine ACHE Newsletter ... newsletter by entering your e-mail address below. Abuse, Post-Traumatic Stress Disorder and Migraine Gretchen E. ...

  20. Traumatic grief and traumatic stress in survivors 12 years after the genocide in Rwanda.

    Science.gov (United States)

    Mutabaruka, Jean; Séjourné, Nathalène; Bui, Eric; Birmes, Philippe; Chabrol, Henri

    2012-10-01

    The relationship between exposure to traumatic events and traumatic grief and the role of mediating and moderating variables [peritraumatic distress, post traumatic stress disorder (PTSD) symptoms and symptoms of depression] were studied in survivors of the genocide of Batutsi in Rwanda in 1994. One hundred and two survivors (70 women, mean age 45 ± 7.53 years) participated in this retrospective study. All of them had lost a member of their family. The severity of traumatic exposure (Comprehensive Trauma Inventory), peritraumatic distress (Peritraumatic Distress Inventory), current PTSD symptoms (PTSD Checklist), depressive symptoms (Beck Depression Inventory) and traumatic grief symptoms (Inventory of Traumatic Grief) was evaluated. A hierarchical multiple regression analysis was then conducted to examine the relative contribution of each variable to the symptoms of traumatic grief. The severity of traumatic exposure was related to traumatic grief symptoms (B=0.06, R=0.6, R(2) =0.36 and ß=0.6, t=7.54, p=0.00). The Baron and Kenny procedure (1986) (including three separate regressions), along with the Sobel test, was used to test mediation effects. Peritraumatic distress and PTSD symptoms may be mediating variables between traumatic exposure and traumatic grief. Traumatic grief is a complex but assessable entity, where previous distress and suffering result from both psychological trauma and the loss of a loved one. PMID:22282057

  1. Endovascular diagnosis and therapy for traumatic arteriovenous fistulas:an analysis of 108 cases

    International Nuclear Information System (INIS)

    Objective: To analyze the clinical features, angiographic manifestations, angiographic techniques and the optimal therapeutic schemes for traumatic arteriovenous fistulae (AVF). Methods: The clinical data and interventional therapeutic results of all patients with traumatic arteriovenous fistulas encountered at Kings County Hospital Center during the period of 1977-2005 were retrospectively reviewed and analyzed. The items for analysis included the mechanism of injury, the clinical manifestations, the traumatic sites, abnormal angiographic findings, the presence or absence of false aneurysm, the flow dynamic characteristics of AVFs, which was divided into five patterns, and the method of treatment. The results were analyzed and evaluate. Results: A total of 117 AVFs were found in 108 patients. All the diagnoses were confirmed by angiography. In most patients the clinical symptoms of AVF were either absent or unrecognizable before angiography. Mechanisms of injury included gunshot wound (72 AVFs), stab wound (24 AVFs), blunt trauma (8 AVFs), injury by falling (3 AVFs) and iatrogenic during the management of trauma (2 AVFs). The common traumatic locations included the extremities (46 cases), the neck (19 cases), the liver (13 cases), and subclavian vessels (11 cases). Early venous opacification was seen in all cases. The AVFs were associated with false aneurysms in 49.6% of patients. The most common pattern of the flow dynamics was type I (40 AVFs, 34.2%), namely both the proximal and distal segments of both artery and vein of AVF were displayed with the presence of incompetent distal venous valves. Next common pattern was type III (22 AVFs, 18.8%), and the most uncommon pattern was type V (5 AVFs, 4.3%). Half of the AVFs had retrograde arterial flow contribution from distal collaterals. Surgery was carried out in 34 patients. Clinical observation was employed in 7 and embolization therapy was adopted in 61 patients. The embolic agents included coils (n = 47

  2. Treatment of an Aortic Traumatic Double Rupture

    Directory of Open Access Journals (Sweden)

    Attinà Domenico

    2015-03-01

    Full Text Available Traumatic thoracic aortic rupture is a life-threatening condition; aortic isthmus is the most common site of rupture, but in rare cases traumatic injury can localize elsewhere, such as at aortic arch or at the level of the diaphragm. In the past few years, endovascular treatment of traumatic aortic injury became a safe procedure, with lower mortality and complication, if compared with open surgery. We report a case of a 40-year-old-man admitted to emergency department after a violent car crash in which an aortic traumatic double rupture was successfully treated with two endovascular stent-grafts coverage.

  3. Cerebral Blood Flow and Autoregulation after Pediatric Traumatic Brain Injury

    OpenAIRE

    Udomphorn, Yuthana; Armstead, William M.; Vavilala, Monica S.

    2008-01-01

    Traumatic brain injury is a global health concern and is the leading cause of traumatic morbidity and mortality in children. Despite a lower overall mortality than in adult traumatic brain injury, the cost to society from the sequelae of pediatric traumatic brain injury is very high. Predictors of poor outcome after traumatic brain injury include altered systemic and cerebral physiology, including altered cerebral hemodynamics. Cerebral autoregulation is often impaired following traumatic bra...

  4. Value of ultrasound in the evaluation of blunt abdominal trauma

    International Nuclear Information System (INIS)

    Trauma is a major cause of morbidity and mortality in an age group including from teenagers to young adults, in a male dominant proportion, resulting in great economic and social impact. Within the complex of trauma, blunt abdominal trauma (BAT) is frequent event and presents difficulty in the evaluation and management since the clinical examination shows low sensitivity and specificity. The detection of hemo peritoneum is one of the methods of evaluation of possible indirect intra-abdominal injuries, initially using direct diagnostic abdominal paracentesis and posteriorly the diagnostic peritoneal lavage, that despite the effectiveness, have drawbacks such as invasiveness and the inability of hemo peritoneum quantification and the lesion staging, resulting in non-therapeutic laparotomies. Imaging methods provide useful information in the investigation of abdominal injuries, such as conventional and contrast radiology, ultrasound (US) and computed tomography (CT), which is the best effective method, but has its own drawbacks, such as cost, accessibility, use of ionizing radiation and contrast media and the displacement of the patient to the machine. US presents itself as an alternative in the initial evaluation of these patients as noninvasive method, with lack of harmfulness, low cost, fast answer and portability. Nevertheless, this method also has its limitations, as in cases of abdominal injuries without free fluid. This study was conducted in order to establish the performance of the US in this setting, allowing to rationalise the use of CT. For this purpose we studied 163 patients treated in the ER of HC/FMUSP, with the completion of consecutive US and CT. The population fits the usual profile of trauma victims, with 83% male, 56% in the age group between 20 and 39 years and in 73% of cases victims of traffic accidents. They were brought to the service in an average time of 51 minutes, mainly stable and with satisfactory level of consciousness. US took on

  5. Drag reduction of a blunt trailing-edge airfoil

    Science.gov (United States)

    Baker, Jonathon Paul

    Wind-tunnel experimentation and Reynolds-averaged Navier--Stokes simulations were used to analyze simple, static trailing-edge devices applied to an FB-3500-1750 airfoil, a 35% thick airfoil with a 17.5% chord blunt trailing edge, in order to mitigate base drag. The drag reduction devices investigated include Gurney-type tabs, splitter plates, base cavities, and offset cavities. The Gurney-type tabs consisted of small tabs, attached at the trailing edge and distributed along the span, extending above the upper and lower surfaces of the airfoil. The Gurney-type devices were determined to have little drag reduction capabilities for the FB-3500-1750 airfoil. Splitter plates, mounted to the center of the trailing edge, with lengths between 50% and 150% of the trailing-edge thickness and various plate angles (0° and +/-10° from perpendicular) were investigated and shown to influence the lift and drag characteristics of the baseline airfoil. Drag reductions of up to 50% were achieved with the addition of a splitter plate. The base cavity was created by adding two plates perpendicular to the trailing edge, extending from the upper and lower surfaces of the airfoil. The base cavity demonstrated possible drag reductions of 25%, but caused significant changes to lift, primarily due to the method of device implementation. The offset cavity, created by adding two splitter plates offset from the upper and lower surfaces by 25% of the trailing-edge thickness, was shown to improve on the drag reductions of the splitter plate, while also eliminating unsteady vortex shedding prior to airfoil stall.

  6. Blunted Activation of Rho-Kinase in Yak Pulmonary Circulation

    Directory of Open Access Journals (Sweden)

    Takeshi Ishizaki

    2015-01-01

    Full Text Available Yaks have adapted to high altitude and they do not develop hypoxic pulmonary hypertension. Although we previously identified the important role of augmented nitric oxide synthase activity in the yak pulmonary circulatory system, evidence of the direct involvement of Rho-kinase as a basal vascular tone regulator is lacking. Four domesticated male pure-bred yaks and four bulls that were born and raised at an altitude of 3000 m in the Tien-Shan mountains were studied at an altitude of 3,100 m. Mean pulmonary artery pressure (mPAP was measured before and after fasudil (60 mg in 20 mL of saline was intravenously administered using a Swan-Ganz catheter at a rate of 3.3 mL/min for 30 min. Fasudil decreased mPAP in bulls from 67.8±14.9 to 32.3±5.3 mmHg (P<0.05 after 15 min and the level was maintained for 30 min, but it merely blunted mPAP in yaks from 28.2±4.5 to 25.1±11.1 and 23.2±2.7 mmHg after 5 and 30 min, respectively. These findings comprise the first evidence of a modest role of Rho-kinase in the maintenance of pulmonary artery pressure in the yak.

  7. Blunted activation of Rho-kinase in yak pulmonary circulation.

    Science.gov (United States)

    Ishizaki, Takeshi; Mizuno, Shiro; Sakai, Akio; Matsukawa, Shigeru; Kojonazarov, Baktybek; Zamirbek, Baiserkeev; Umeda, Yukihiro; Morikawa, Miwa; Anzai, Masaki; Ishizuka, Tamotsu; Aldashev, Almaz

    2015-01-01

    Yaks have adapted to high altitude and they do not develop hypoxic pulmonary hypertension. Although we previously identified the important role of augmented nitric oxide synthase activity in the yak pulmonary circulatory system, evidence of the direct involvement of Rho-kinase as a basal vascular tone regulator is lacking. Four domesticated male pure-bred yaks and four bulls that were born and raised at an altitude of 3000 m in the Tien-Shan mountains were studied at an altitude of 3,100 m. Mean pulmonary artery pressure (mPAP) was measured before and after fasudil (60 mg in 20 mL of saline) was intravenously administered using a Swan-Ganz catheter at a rate of 3.3 mL/min for 30 min. Fasudil decreased mPAP in bulls from 67.8±14.9 to 32.3±5.3 mmHg (P < 0.05) after 15 min and the level was maintained for 30 min, but it merely blunted mPAP in yaks from 28.2±4.5 to 25.1±11.1 and 23.2±2.7 mmHg after 5 and 30 min, respectively. These findings comprise the first evidence of a modest role of Rho-kinase in the maintenance of pulmonary artery pressure in the yak. PMID:25654121

  8. CT findings of bowel injury following blunt abdominal trauma

    International Nuclear Information System (INIS)

    To determine the diagnostic value of CT, the author retrospectively reviewed preoperative CT findings of 57 cases with surgically proven bowel injury following blunt trauma. The small bowel injuries were divided into two groups, i.e., those without mesenteric injury, group A, and those with mesenteric injury, group B. The incidence of CT findings including extraluminal air, bowel wall thickening, peritoneal fluid, mesenteric thickening, and high density hematoma, were determined. CT findings were also assessed by time intervals between injury and examination. CT scans of small bowel injury were compared with those of surgically proven 25 cases of mesenteric injury without bowel injury, group C. CT showed findings suggestive of bowel injury in 96.4% of the cases. There were 5 false negative CT scans, which consisted of 4 small bowel and one large bowel injuries, all performed within 2 hours from injury. The patients in group A small bowel injury had a higher incidence of pneumoperitoneum on CT scans performed over 4 hours after injury than on those performed within 4 hours. Bowel wall thickening was more frequent in group A than in group B or C. Peritoneal fluid collection within 4 hours from injury was less frequent in group A than in group B or C. High density hematoma was more frequent in group B and C than in group A. The analysis suggested that early diagnosis of isolated small bowel injury was difficult because of lack of signs indicating mesenteric injury. In these cases bowel wall thickening appeared earlier, then peritoneal fluid developed, with and without mesenteric thickening or extraluminal air. Thus in those with suspicion of bowel injury, bowel wall thickening on initial CT should be carefully followed up in regard to additional or progressive findings. Operative indication can be determined with careful clinical correlation before detection of extraluminal air. (K.H.)

  9. Blunt impacts to the back: Biomechanical response for model development.

    Science.gov (United States)

    Forman, Jason; Perry, Brandon; Henderson, Kyvory; Gjolaj, Joseph P; Heltzel, Sara; Lessley, David; Riley, Patrick; Salzar, Robert; Walilko, Tim

    2015-09-18

    The development of advanced injury prediction models requires biomechanical and injury tolerance information for all regions of the body. While numerous studies have investigated injury mechanics of the thorax under frontal impact, there remains a dearth of information on the injury mechanics of the torso under blunt impact to the back. A series of hub-impact tests were performed to the back surface of the mid-thorax of four mid-size male cadavers. Repeated tests were performed to characterize the biomechanical and injury response of the thorax under various impact speeds (1.5m/s, 3m/s and 5.5m/s). Deformation of the chest was recorded with a 59-gage chestband. Subject kinematics were also recorded with a high-speed optoelectronic 3D motion capture system. In the highest-severity tests, peak impact forces ranged from 6.9 to 10.5 kN. The peak change in extension angle measured between the 1st thoracic vertebra and the lumbar spine ranged from 39 to 62°. The most commonly observed injuries were strains of the costovertebral/costotransverse joint complexes, rib fractures, and strains of the interspinous and supraspinous ligaments. The majority of the rib fractures occurred in the rib neck between the costovertebral and costotransverse joints. The prevalence of rib-neck fractures suggests a novel, indirect loading mechanism resulting from bending moments generated in the rib necks caused by motion of the spine. In addition to the injury information, the biomechanical responses quantified here will facilitate the future development and validation of human body models for predicting injury risk during impact to the back. PMID:26184586

  10. Prehospital advanced trauma life support for critical blunt trauma victims.

    Science.gov (United States)

    Cwinn, A A; Pons, P T; Moore, E E; Marx, J A; Honigman, B; Dinerman, N

    1987-04-01

    The ability of paramedics to deliver advanced trauma life support (ATLS) in an expedient fashion for victims of trauma has been strongly challenged. In this study, the records of 114 consecutive victims of blunt trauma who underwent laparotomy or thoracotomy were reviewed. Prehospital care was rendered by paramedics operating under strict protocols. The mean response time (minutes +/- SEM) to the scene was 5.6 +/- 0.27. On-scene time was 13.9 +/- 0.62. The time to return to the hospital was 8.0 +/- 0.4. On-scene time included assessing hazards at the scene, patient extrication, spine immobilization (n = 98), application of oxygen (n = 94), measurement of vital signs (n = 114), splinting of 59 limbs, and the following ATLS procedures: endotracheal intubation (n = 31), IV access (n = 106), ECG monitoring (n = 69), procurement of blood for tests including type and cross (n = 58), and application of a pneumatic antishock garment (PASG) (n = 31). On-scene times were analyzed according to the number of ATLS procedures performed: insertion of one IV line (n = 46), 14.8 +/- 1.03 minutes; two IV lines (n = 28), 13.4 +/- 0.92; one IV line plus intubation (n = 7), 14.0 +/- 2.94; two IV lines plus intubation (n = 9), 17.0 +/- 2.38; and two IV lines plus intubation plus PASG (n = 13), 12.4 +/- 1.36. Of the 161 IV attempts, 94% were completed successfully. Of 36 attempts at endotracheal intubation, 89% were successful.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3826807

  11. Effects of Copper, Zinc, and Vitamin Complex (Cernevit®) on Hepatic Healing in Rats Experimentally Subjected to Blunt Hepatic Trauma.

    Science.gov (United States)

    Ayten, Refik; Aygen, Erhan; Cerrahoglu, Yusuf Ziya; Camci, Cemalettin; Ilhan, Yavuz Selim; Girgin, Mustafa; Ilhan, Necip; Ozercan, Ibrahim Hanefi

    2015-12-01

    Solid organ injuries following blunt trauma are frequently encountered. The use of non-operative approach is gradually increasing. Thus, research on the methods that could enhance healing in solid organ injuries is in progress. Agents known to have antioxidant property were used after an experimentally induced blunt hepatic trauma. Thirty-two Wistar albino rats weighing 200 g were dropped from a height of 40 cm on to the right upper abdominal quadrant to produce a grade II-III hepatic injury. Rats were divided into control, Zn-administered, Cu-administered, and vitamin complex-administered groups, with eight rats in each. Aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) levels were measured in the blood samples. The percentage of cells displaying Ki-67 nuclear staining was estimated. The sections were stained with hematoxylin and eosin and the degree of inflammation in the samples was semi-quantitatively assessed. Treatment with zinc, copper, and Cernevit® caused varying levels of decrease in AST, ALT, and LDH levels compared to the control group. Ki-67 positivity was significantly lower in group I compared with groups II and III (p = 0.002). Ki-67 positivity was significantly higher in group II compared to the other groups (p < 0.05). A marked improvement was observed in inflammation in group II. Copper and zinc treatment decreased inflammation as well as blood levels of AST and ALT, and enhanced the healing of traumatized hepatic tissue. However, Cernevit® reduced only the degree of inflammation. PMID:27011508

  12. SOCIO-DEMOGRAPHIC PROFILE OF TRAUMATIC CATARACT IN WESTERN ODISHA: A STUDY AT A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Samarth Mishra

    2016-06-01

    Full Text Available AIM Ocular injuries are common in all age groups, be it from blunt trauma like cricket ball, bat, etc or penetrating injury from pen, pencil or stick with cataract being the most common complication. Other complications like corneal perforation with or without iris prolapse, total hyphema, lens subluxation with or without posterior capsular rupture, iridodialysis, uveitis, vitreous haemorrhage, retinal detachment, etc. may occur. The aim of the study was to find out the various causes of traumatic cataract and associated socio-demographic profile in western Odisha, in a single tertiary care centre. MATERIALS AND METHODS Retrospective study was conducted on 76 patients who had traumatic cataract and were admitted to VSS Institute of Medical Sciences and Research (VIMSAR, Burla, Odisha from March 2014 to March 2016, a total period of 2 years. Data related to the type of injury, duration of presentation, age, sex, occupation and initial visual acuity were taken. B-scans were done for all cases. X-ray and CT scans were done wherever required. RESULTS Traumatic injuries were most common in children and young adults. 27 cases (35.52% were children in age group less than 10 years. The incidences decreased with increase in age and were less frequent in the elderly. The most common form of injury was penetrating injury with stick injury as the cause in 19 cases (25%, followed by pen (19.73% and pencil (14.47%. Males were injured more frequently (63.15% than females (36.84%. 59 patients presented within 24 hours of injury which comprised 77.63% in total. Though most had poor visual acuity at initial presentation, postoperative prognosis was found to be good in general, if not associated with any other complications. CONCLUSION Since traumatic cataract is common in childhood, parents should be vigilant and should prohibit the use of sharp instruments in children. Occupational workers should use protective eye gears to avoid untoward incident. Though

  13. Post-traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    M Yadollahie

    2011-12-01

    Full Text Available Unexpected extreme sudden traumatic stressor may cause post-traumatic stress disorder (PTSD. Important traumatic events include war, violent personal assault (e.g., sexual assault, and physical attack, being taken hostage or kidnapped, confinement as a prisoner of war, torture, terrorist attack, severe car accidents, and natural disasters. In childhood age sexual abuse or witnessing serious injuries or unexpected death of a beloved one are among important traumatic events.PTSD can be categorized into two types of acute and chronic PTSD: if symptoms persist for less than three months, it is termed “acute PTSD,” otherwise, it is called “chronic PTSD.” 60.7% of men and 51.2% of women would experience at least one potentially traumatic event in their lifetime. The lifetime prevalence of PTSD is significantly higher in women than men. Lifetime prevalence of PTSD varies from 0.3% in China to 6.1% in New Zealand. The prevalence of PTSD in crime victims are between 19% and 75%; rates as high as 80% have been reported following rape. The prevalence of PTSD among direct victims of disasters was reported to be 30%–40%; the rate in rescue workers was 10%–20%. The prevalence of PTSD among police, fire, and emergency service workers ranged from 6%–32%. An overall prevalence rate of 4% for the general population, the rate in rescue/recovery occupations ranged from 5% to 32%, with the highest rate reported in search and rescue personnel (25%, firefighters (21%, and workers with no prior training for facing disaster. War is one of the most intense stressors known to man. Armed forces have a higher prevalence of depression, anxiety disorders, alcohol abuse and PTSD. High-risk children who have been abused or experienced natural disasters may have an even higher prevalence of PTSD than adults.Female gender, previous psychiatric problem, intensity and nature of exposure to the traumatic event, and lack of social support are known risk factors for work

  14. Emergency resuscitative thoracotomy performed in European civilian trauma patients with blunt or penetrating injuries: a systematic review

    OpenAIRE

    Narvestad, Jon; Meskinfamfard, M.; Søreide, Kjetil

    2015-01-01

    Purpose: Emergency resuscitative thoracotomy (ERT) is a lifesaving procedure in selected patients. Indications are still being debated, but outcome in blunt trauma is believed to be poor. Recent reports from European populations, where blunt trauma predominates, have suggested favorable outcome also in blunt trauma. Our aim was to identify all European studies reported over the last decade and compare reported outcomes to existing knowledge. Methods: We performed a systematic literature se...

  15. Secondary Traumatic Stress in Substance Abuse Treatment

    Science.gov (United States)

    Bride, Brian E.; Walls, Erin

    2006-01-01

    The terms secondary traumatic stress (STS), vicarious traumatization (VT), and compassion fatigue (CF) have all been used, sometimes interchangeably, to refer to the observation that those who provide clinical services to trauma survivors may themselves experience considerable emotional disruption, becoming indirect victims of the trauma.…

  16. Traumatic Bonding: Clinical Implications in Incest.

    Science.gov (United States)

    deYoung, Mary; Lowry, Judith A.

    1992-01-01

    "Traumatic bonding" is defined as "the evolution of emotional dependency between...a child and an adult [in] a relationship characterized by periodic sexual abuse." Maintains that the concept holds promise for explaining confusing dynamics of incest. Demonstrates ways in which traumatic bonding can be applied to cases of incest and discusses…

  17. Effect of Temperature-Sensitive Poloxamer Solution/Gel Material on Pericardial Adhesion Prevention: Supine Rabbit Model Study Mimicking Cardiac Surgery.

    Directory of Open Access Journals (Sweden)

    Hyun Kang

    Full Text Available We investigated the mobility of a temperature-sensitive poloxamer/Alginate/CaCl2 mixture (PACM in relation to gravity and cardiac motion and the efficacy of PACM on the prevention of pericardial adhesion in a supine rabbit model.A total of 50 rabbits were randomly divided into two groups according to materials applied after epicardial abrasion: PACM and dye mixture (group PD; n = 25 and saline as the control group (group CO; n = 25. In group PD, rabbits were maintained in a supine position with appropriate sedation, and location of mixture of PACM and dye was assessed by CT scan at the immediate postoperative period and 12 hours after surgery. The grade of adhesions was evaluated macroscopically and microscopically two weeks after surgery.In group PD, enhancement was localized in the anterior pericardial space, where PACM and dye mixture was applied, on immediate post-surgical CT scans. However, the volume of the enhancement was significantly decreased at the anterior pericardial space 12 hours later (P < .001. Two weeks after surgery, group PD had significantly lower macroscopic adhesion score (P = .002 and fibrosis score (P = .018 than did group CO. Inflammation score and expression of anti-macrophage antibody in group PD were lower than those in group CO, although the differences were not significant.In a supine rabbit model study, the anti-adhesion effect was maintained at the area of PACM application, although PACM shifted with gravity and heart motion. For more potent pericardial adhesion prevention, further research and development on the maintenance of anti-adhesion material position are required.

  18. Sleep in traumatic brain injury.

    Science.gov (United States)

    Vermaelen, James; Greiffenstein, Patrick; deBoisblanc, Bennett P

    2015-07-01

    More than one-half million patients are hospitalized annually for traumatic brain injury (TBI). One-quarter demonstrate sleep-disordered breathing, up to 50% experience insomnia, and half have hypersomnia. Sleep disturbances after TBI may result from injury to sleep-regulating brain tissue, nonspecific neurohormonal responses to systemic injury, ICU environmental interference, and medication side effects. A diagnosis of sleep disturbances requires a high index of suspicion and appropriate testing. Treatment starts with a focus on making the ICU environment conducive to normal sleep. Treating sleep-disordered breathing likely has outcome benefits in TBI. The use of sleep promoting sedative-hypnotics and anxiolytics should be judicious. PMID:26118920

  19. Traumatic injuries of the hip.

    LENUS (Irish Health Repository)

    Marshall, Nina

    2009-11-01

    Traumatic lesions of the hip in athletes may be clinically challenging because of the overlap in clinical presentation due to differing pathologies and the presence of multiple injuries. Imaging of the hip in the athlete has undergone a recent resurgence of interest and understanding related to the increasing accessibility and use of hip arthroscopy, which expands the treatment options available for intra-articular pathology. MR imaging and MR arthrography have a unique role in diagnosis of these pathologies, guiding the surgeon, arthroscopist, and referring clinician in their management of bony and soft tissue injury.

  20. Traumatic subarachnoid-pleural fistula

    International Nuclear Information System (INIS)

    Traumatic subarachnoid-pleural fistulas are rare. The authors found nine cases reported since 1959. Seven have been secondary to trauma and two following thoracotomy. One patient's death is thought to be directly related to the fistula. The diagnosis should be suspected in patients with a pleural effusion and associated vertebral trauma. The diagnosis can usually be confirmed with contrast or radioisotopic myelography. Successful closure of the fistula will usually occur spontaneously with closed tube drainage and antibiotics; occasionally, thoracotomy is necessary to close the rent in the dura

  1. Disruption of caudate working memory activation in chronic blast-related traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Mary R. Newsome

    2015-01-01

    Full Text Available Mild to moderate traumatic brain injury (TBI due to blast exposure is frequently diagnosed in veterans returning from the wars in Iraq and Afghanistan. However, it is unclear whether neural damage resulting from blast TBI differs from that found in TBI due to blunt-force trauma (e.g., falls and motor vehicle crashes. Little is also known about the effects of blast TBI on neural networks, particularly over the long term. Because impairment in working memory has been linked to blunt-force TBI, the present functional magnetic resonance imaging (fMRI study sought to investigate whether brain activation in response to a working memory task would discriminate blunt-force from blast TBI. Twenty-five veterans (mean age = 29.8 years, standard deviation = 6.01 years, 1 female who incurred TBI due to blast an average of 4.2 years prior to enrollment and 25 civilians (mean age = 27.4 years, standard deviation = 6.68 years, 4 females with TBI due to blunt-force trauma performed the Sternberg Item Recognition Task while undergoing fMRI. The task involved encoding 1, 3, or 5 items in working memory. A group of 25 veterans (mean age = 29.9 years, standard deviation = 5.53 years, 0 females and a group of 25 civilians (mean age = 27.3 years, standard deviation = 5.81 years, 0 females without history of TBI underwent identical imaging procedures and served as controls. Results indicated that the civilian TBI group and both control groups demonstrated a monotonic relationship between working memory set size and activation in the right caudate during encoding, whereas the blast TBI group did not (p < 0.05, corrected for multiple comparisons using False Discovery Rate. Blast TBI was also associated with worse performance on the Sternberg Item Recognition Task relative to the other groups, although no other group differences were found on neuropsychological measures of episodic memory, inhibition, and general processing speed. These results

  2. Sarcoidosis in a 65-year-old woman presenting with a lung mass and pericardial effusion: a case report

    Directory of Open Access Journals (Sweden)

    Margaritopoulos George A

    2012-08-01

    Full Text Available Abstract Introduction Sarcoidosis is a multi-systemic disorder of unknown origin and most commonly affects the lungs. Diagnosis relies on the presence of non-caseating granulomas on histologic specimens. In high-resolution computed tomography, the most characteristic findings are peribronchovascular thickening, perilymphatic nodular distribution, and bilateral hilar adenopathy. Confluent nodular opacities or large masses are rare manifestations of the disease. It is well recognized that sarcoidosis can mimic infectious, malignant, and granulomatous conditions. Here, we report a case with a high initial index of suspicion for lung malignancy in terms of clinical, lung imaging, and endoscopic findings. Case presentation A 65-year-old Caucasian woman, lifelong non-smoker with an unremarkable medical history, presented with a 10-month history of progressive breathlessness, dry cough, fatigue, arthralgias, and mild weight loss. The only significant clinical finding was bilateral enlargement of auxiliary lymph nodes. High-resolution computed tomography revealed a soft tissue density mass at the right hilum which was surrounding and narrowing airways and vascular components, nodules with vascular distribution, enlarged mediastinal lymph nodes, and pericardial effusion. Our patient underwent a bronchoscopy, which revealed the presence of submucosal infiltration and narrowing of the right upper bronchus. Endobronchial biopsies showed non-caseating granulomas. As local sarcoid reactions with non-caseating granulomas can be observed near tumors, our patient underwent video-assisted thoracoscopy and surgical removal of an auxiliary lymph node, both of which confirmed the presence of non-caseating granulomas and the diagnosis of sarcoidosis. She was treated with steroids with improvement of clinical and imaging findings. However, while on a maintenance dose, she presented with a pleural effusion, which, after the diagnostic work-up, proved to be sarcoidosis

  3. Shielding effect and emission criterion of a screw dislocation near an interfacial blunt crack

    International Nuclear Information System (INIS)

    Shielding effect and emission criterion of a screw dislocation near an interfacial blunt crack are dealt with in this paper. Utilizing the conformal mapping technique, the closed-form solutions are derived for complex potentials and stress fields due to a screw dislocation located near the interfacial blunt crack. The stress intensity factor on the crack tips and the critical stress intensity factor for dislocation emission are also calculated. The influence of the orientation of the dislocation and the morphology of the blunt crack as well as the material elastic dissimilarity on the shielding effect and the emission criterion is discussed in detail. The results show that positive screw dislocations can reduce the stress intensity factor of the interfacial blunt crack tip (shielding effect). The shielding effect increases with the increase of the shear modulus of the lower half-plane, but it decreases with the increase of the dislocation azimuth angle. The critical loads at infinity for dislocation emission increases with the increase of emission angle and curvature radius of blunt crack tip, and the most probable angle for screw dislocation emission is zero. The present solutions contain previous results as special cases. (condensed matter: structure, thermal and mechanical properties)

  4. Involvement of the mirror neuron system in blunted affect in schizophrenia.

    Science.gov (United States)

    Lee, Jung Suk; Chun, Ji Won; Yoon, Sang Young; Park, Hae-Jeong; Kim, Jae-Jin

    2014-01-01

    Blunted affect is a relatively enduring schizophrenic symptom and its presence brings about poor functioning and outcomes. Functional impairment in the mirror neuron system which is involved in both motor execution and imitation may be a neural basis of blunted affect, but it is not proved yet. Fifteen patients with schizophrenia and 16 healthy controls performed the facial expression task during functional magnetic resonance imaging. The task was to reproduce facial expressions in response to the face or word stimuli for happiness, sadness, and meaningless expression. Brain activities during facial expressions in patients compared with controls and their relationship with affective flattening were analyzed. Compared to controls, patients exhibited decreased activity in the widespread dorsal frontal regions and increased activity in the ventral frontal and subcortical regions. Patients also demonstrated significant negative correlation of the severity of affective flattening with activities in the mirror neuron system, such as the premotor cortex, motor cortex, and inferior parietal lobule. Emotional expression in patients with schizophrenia may be related to hypoactivity of the dorsal system and hyperactivity of the ventral system. An imbalance of these two systems may contribute to blunted affect. Directly addressing blunted affect using emotional expression provides a new perspective that functional disturbance of the mirror neuron system may play an important role in manifestation of blunted affect in schizophrenia. PMID:24268934

  5. Bilateral ureteropelvic disruption following blunt abdominal trauma: Case report

    Directory of Open Access Journals (Sweden)

    Kikuchi Hiroko

    2011-07-01

    Full Text Available Abstract Background Ureteral injury occurs in less than 1% of blunt abdominal trauma cases, partly because the ureters are relatively well protected in the retroperitoneum. Bilateral ureteral injury is extremely rare, with only 10 previously reported cases. Diagnosis may be delayed if ureteric injury is not suspected, and delay of 36 hours or longer has been observed in more than 50% of patients with ureteric injury following abdominal trauma, leading to increased morbidity. Case presentation A 29-year-old man was involved in a highway motor vehicle collision and was ejected from the front passenger seat even though wearing a seatbelt. He was in a preshock state at the scene of the accident. An intravenous line and left thoracic drain were inserted, and he was transported to our hospital by helicopter. Whole-body, contrast-enhanced computed tomography (CT scan showed left diaphragmatic disruption, splenic injury, and a grade I injury to the left kidney with a retroperitoneal haematoma. He underwent emergency laparotomy. The left diaphragmatic and splenic injuries were repaired. Although a retroperitoneal haematoma was observed, his renal injury was treated conservatively because the haematoma was not expanding. In the intensive care unit, the patient's haemodynamic state was stable, but there was no urinary output for 9 hours after surgery. Anuresis prompted a review of the abdominal x-ray which had been performed after the contrast-enhanced CT. Leakage of contrast material from the ureteropelvic junctions was detected, and review of the repeat CT scan revealed contrast retention in the perirenal retroperitoneum bilaterally. He underwent cystoscopy and bilateral retrograde pyelography, which showed bilateral complete ureteral disruption, preventing placement of ureteral stents. Diagnostic laparotomy revealed complete disruption of the ureteropelvic junctions bilaterally. Double-J ureteral stents were placed bilaterally and ureteropelvic

  6. Choroidal neovascularization after blunt ocular trauma in angioid streaks

    Directory of Open Access Journals (Sweden)

    Kubota M

    2013-07-01

    Full Text Available Masaomi Kubota, Takaaki Hayashi, Kota Arai, Hiroshi TsuneokaDepartment of Ophthalmology, The Jikei University School of Medicine, Tokyo, JapanBackground: Patients with angioid streaks are prone to develop a subretinal hemorrhage after ocular injury, due to fragility of Bruch's membrane.Objective: The purpose of this study was to report a patient with angioid streaks in whom subfoveal choroidal neovascularization (CNV developed after blunt ocular trauma.Case report: A 60-year-old man was accidentally struck in the left eye with a crowbar handle while engaged in the demolition of wooden building materials in May 2011 and was initially evaluated at our hospital. Corrected visual acuity was 0.3 in the right and 1.2 in the left eye, and relative afferent pupillary defect was negative. Funduscopy revealed choroidal atrophy around the optic papillae and angioid streaks radiating from around the optic discs in both eyes. In the right eye, there was macular atrophy. In the left eye, there was a subretinal hemorrhage around the macular region. Fluorescein angiography of the left eye showed a blockage due to subretinal hemorrhage and increasing hyperfluorescent spots superior to the fovea, suggestive of extrafoveal CNV. Spectral-domain optical coherence tomography showed macular thinning in the right eye and no obvious abnormalities near the subfoveal region in the left eye. Two months later, the patient noticed decreased visual acuity in the left eye and was reevaluated. Visual acuity had decreased to 0.7, and well-defined CNV, one disc diameter in size, was presenting slightly superior to the macula, including the subfoveal region. Two weeks later, anti-vascular endothelial growth factor (anti-VEGF antibody (bevacizumab was injected intravitreally; the CNV then regressed, and visual acuity improved to 1.2.Conclusion: Marked improvement in visual acuity with early treatment has not been reported in angioid streaks with subfoveal CNV after ocular injury

  7. Characterization of pressure distribution in penetrating traumatic brain injuries.

    Science.gov (United States)

    Davidsson, Johan; Risling, Mårten

    2015-01-01

    Severe impacts to the head commonly lead to localized brain damage. Such impacts may also give rise to temporary pressure changes that produce secondary injuries in brain volumes distal to the impact site. Monitoring pressure changes in a clinical setting is difficult; detailed studies into the effect of pressure changes in the brain call for the development and use of animal models. The aim of this study is to characterize the pressure distribution in an animal model of penetrating traumatic brain injuries (pTBI). This data may be used to validate mathematical models of the animal model and to facilitate correlation studies between pressure changes and pathology. Pressure changes were measured in rat brains while subjected to pTBI for a variety of different probe velocities and shapes; pointy, blunt, and flat. Experiments on ballistic gel samples were carried out to study the formation of any temporary cavities. In addition, pressure recordings from the gel experiments were compared to values recorded in the animal experiments. The pTBI generated short lasting pressure changes in the brain tissue; the pressure in the contralateral ventricle (CLV) increased to 8 bar followed by a drop to 0.4 bar when applying flat probes. The pressure changes in the periphery of the probe, in the Cisterna Magna, and the spinal canal, were significantly less than those recorded in the CLV or the vicinity of the skull base. High-speed videos of the gel samples revealed the formation of spherically shaped cavities when flat and spherical probes were applied. Pressure changes in the gel were similar to those recorded in the animals, although amplitudes were lower in the gel samples. We concluded cavity expansion rate rather than cavity size correlated with pressure changes in the gel or brain secondary to probe impact. The new data can serve as validation data for finite element models of the trauma model and the animal and to correlate physical measurements with secondary injuries

  8. Effect of cocaine use on outcomes in traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Jacky T Yeung

    2013-01-01

    Full Text Available Context: Animal and molecular studies have shown that cocaine exerts a neuroprotective effect against cerebral ischemia. Aims: To determine if the presence of cocaine metabolites on admission following traumatic brain injury (TBI is associated with better outcomes. Settings and Design: Level-1 trauma center, retrospective cohort. Materials and Methods: After obtaining Institutional Review Board (IRB approval, the trauma registry was searched from 2006 to 2009 for all patients aged 15-55 years with blunt head trauma and non-head AIS <3. Exclusion criteria were pre-existing brain pathology and death within 30 min of admission. The primary outcome was in-hospital mortality; secondary outcomes were hospital length of stay (LOS, and Glasgow Outcome Score (GOS. Statistical Analysis: Logistic regression was used to determine the independent effect of cocaine on mortality. Hospital LOS was compared with multiple linear regression. Results: A total of 741 patients met criteria and had drug screens. The screened versus unscreened groups were similar. Cocaine positive patients were predominantly African-American (46% vs. 21%, P < 0.0001, older (40 years vs. 30 years, P < 0.0001, and had ethanol present more often (50.7% vs. 37.8%, P = 0.01. There were no differences in mortality (cocaine-positive 1.4% vs. cocaine-negative 2.7%, P = 0.6 on both univariate and multivariate analysis. Conclusions: Positive cocaine screening was not associated with mortality in TBI. An effect may not have been detected because of the low mortality rate. LOS is affected by many factors unrelated to the injury and may not be a good surrogate for recovery. Similarly, GOS may be too coarse a measure to identify a benefit.

  9. MDCT Findings of Traumatic Adrenal Injury in Children

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Seung Joon; Kim, Jee Eun; Ryu, Il; Kim, Jin Joo; Choi, Hye Young [Gachon University of Medicine and Science, Gil Medical Center, Incheon (Korea, Republic of)

    2011-02-15

    We wanted to evaluate the MDCT findings and concomitant injuries of traumatic adrenal injury in children. Among 375 children who had undergone a MDCT scan for abdominal trauma during the recent five years at our institution, 27 children who had revealed adrenal injury on their CT scan were included in the study. We retrospectively evaluated the causes of the trauma, the patterns of adrenal injury, the associated CT findings and the concomitant injuries of the other organs in the abdomen. We identified 27 children (7.5%) (17 boys and 10 girls, mean age: 9.9 years, range: 2-18 years) with adrenal injury. The causes of adrenal injury were a traffic accident for 20 patients (74%), falls for four patients (15%) and blunt trauma for three patients (11%). The right adrenal gland was injured in 20 patients (74%), while the left adrenal gland was injured in three patients and bilateral involvement was noted in four patients. The patterns of adrenal injury were round or oval shaped hematoma in 23 lesions (74%), irregular hemorrhage with obliterating the gland in six lesions (19%) and active extravasation of contrast material from the adrenal region in two lesions (7%). Concomitant injuries were noted in 22 patients (81%), including 15 patients with liver laceration (56%), 11 patients with lung contusion (41%) and nine patients with renal injury (33%). The frequency of adrenal injury was 7.5%. The right adrenal gland was more frequently involved. Concomitant organ injury was noted 81% of the patients and the most frequently involved organ was the liver (56%)

  10. Traumatic injuries of brachial plexus

    International Nuclear Information System (INIS)

    The authors report their experience in 144 patients with traumatic brachial plexus injury who underwent Direct Cervical Myelography (DCM). Sometimes the diagnostic investigation was completed by CT. Various myelographic patterns are described: pseudomeningocele, missing sheet of the root, scarring lesions. In 9 cases only, myelography was not sufficient to provide a complete diagnosis. The examination showed all plexus roots lacerated in 14 patients, a monoradicular lesion in 75 cases, and no lesion in 26 cases. Twenty-one out of the 26 negative cases were confirmed during surgery, while in 2 patients an intracanalar injury was found, which had not been detected due to the presence of scars. Scars often compress healty roots, and may mask intracanalar injuries. In such cases, and when the spinal cord stretches towards the side of the lesion, Myelo-CT can be useful. DCM proved to be an extremely sensitive and specific method, which can be used as a first-choice radiological procedure in the study of traumatic injuries of the brachial plexus

  11. Traumatic Optic Neuropathy - A Conundrum.

    Science.gov (United States)

    Selvaraj, Vinoth Kanna; Viswanathan, Ramachandran; Devanathan, Vasudevan

    2016-03-01

    Visual impairment following head injury may be an enigma especially if the onset of symptoms were to be few days after the actual trauma and the bias arising out of the initial normal ophthalmological examination is not neutralised by unbiased repeated formal clinical evaluation aided with electrophysiology. We report and discuss here a 32-year-old lady with delayed onset of indirect traumatic visual loss with anaemia who failed to improve after blood transfusion but improved immediately following steroid therapy seven days after trauma. Though steroids have not been shown to have a significant contribution on outcomes following Traumatic optic neuropathy, this report rekindles its role in delayed progressive visual loss following head trauma and the need to re-analyse the role of steroids in patients with delayed progressive visual disturbance following head injury excluding those with acute onset symptoms in view of different pathologies in both these presentations. This paper also highlights potential mechanisms for the two major types of presentation. PMID:27134913

  12. Preconditioning for traumatic brain injury

    Science.gov (United States)

    Yokobori, Shoji; Mazzeo, Anna T; Hosein, Khadil; Gajavelli, Shyam; Dietrich, W. Dalton; Bullock, M. Ross

    2016-01-01

    Traumatic brain injury (TBI) treatment is now focused on the prevention of primary injury and reduction of secondary injury. However, no single effective treatment is available as yet for the mitigation of traumatic brain damage in humans. Both chemical and environmental stresses applied before injury, have been shown to induce consequent protection against post-TBI neuronal death. This concept termed “preconditioning” is achieved by exposure to different pre-injury stressors, to achieve the induction of “tolerance” to the effect of the TBI. However, the precise mechanisms underlying this “tolerance” phenomenon are not fully understood in TBI, and therefore even less information is available about possible indications in clinical TBI patients. In this review we will summarize TBI pathophysiology, and discuss existing animal studies demonstrating the efficacy of preconditioning in diffuse and focal type of TBI. We will also review other non-TBI preconditionng studies, including ischemic, environmental, and chemical preconditioning, which maybe relevant to TBI. To date, no clinical studies exist in this field, and we speculate on possible futureclinical situation, in which pre-TBI preconditioning could be considered. PMID:24323189

  13. Comparison of fatty acid composition of subcutaneous, pericardial and epicardial adipose tissue and atrial tissue in patients with heart disease

    DEFF Research Database (Denmark)

    Echen, Rikke Bulow; Gu, Jiwei; Andreasen, Jan Jesper;

    2016-01-01

    (EPA) and docosahexaenoic acid (DHA), from three different adipose tissue compartments [epicardial (EAT), pericardial (PAT) and subcutaneous (SAT)]. Furthermore, we studied the correlation between the content of EPA and DHA in these compartments and in atrial tissue (AT). METHODS We obtained AT from...... auricles, EAT above the right ventricle, PAT, and SAT below the sternum from 50 patients undergoing cardiac surgery. Samples were frozen at -80°C and the content of n-3 PUFAs determined by gas chromatography with results given in relative weight%. RESULTS EPA and DHA were significantly correlated in EAT......, PAT and SAT with high r-values from 0.70 to 0.87. There was a significant correlation between the content of EPA in adipose tissue and in AT from 0.49 to 0.59, with minor/no correlation between contents of DHA in adipose tissue and in AT. Correlations: DHA / EPA SAT PAT EAT AT SAT 1.00 / 1.00 PAT 0...

  14. Implications of Pericardial, Visceral and Subcutaneous Adipose Tissue on Vascular Inflammation Measured Using 18FDG-PET/CT.

    Directory of Open Access Journals (Sweden)

    Ho Cheol Hong

    Full Text Available Pericardial adipose tissue (PAT is associated with adverse cardiometabolic risk factors and cardiovascular disease (CVD. However, the relative implications of PAT, abdominal visceral and subcutaneous adipose tissue on vascular inflammation have not been explored.We compared the association of PAT, abdominal visceral fat area (VFA, and subcutaneous fat area (SFA with vascular inflammation, represented as the target-to-background ratio (TBR, the blood-normalized standardized uptake value measured using 18F-Fluorodeoxyglucose Positron Emission Tomography (18FDG-PET in 93 men and women without diabetes or CVD. Age- and sex-adjusted correlation analysis showed that PAT, VFA, and SFA were positively associated with most cardiometabolic risk factors, including systolic blood pressure, LDL-cholesterol, triglycerides, glucose, insulin resistance and high sensitive C-reactive proteins (hsCRP, whereas they were negatively associated with HDL-cholesterol. In particular, the maximum TBR (maxTBR values were positively correlated with PAT and VFA (r = 0.48 and r = 0.45, respectively; both P <0.001, whereas SFA showed a relatively weak positive relationship with maxTBR level (r = 0.31, P = 0.003.This study demonstrated that both PAT and VFA are significantly and similarly associated with vascular inflammation and various cardiometabolic risk profiles.

  15. Boundary Layer Transition over Blunt Hypersonic Vehicles Including Effects of Ablation-Induced Out-Gassing

    Science.gov (United States)

    Li, Fei; Choudhari, Meelan; Chang, Chau-Lyan; White, Jeffery

    2011-01-01

    Computations are performed to study the boundary layer instability mechanisms pertaining to hypersonic flow over blunt capsules. For capsules with ablative heat shields, transition may be influenced both by out-gassing associated with surface pyrolysis and the resulting modification of surface geometry including the formation of micro-roughness. To isolate the effects of out-gassing, this paper examines the stability of canonical boundary layer flows over a smooth surface in the presence of gas injection into the boundary layer. For a slender cone, the effects of out-gassing on the predominantly second mode instability are found to be stabilizing. In contrast, for a blunt capsule flow dominated by first mode instability, out-gassing is shown to be destabilizing. Analogous destabilizing effects of outgassing are also noted for both stationary and traveling modes of crossflow instability over a blunt sphere-cone configuration at angle of attack.

  16. Research progress in traumatic brain penumbra

    Institute of Scientific and Technical Information of China (English)

    Wang Kai; Liu Baiyun; Ma Jun

    2014-01-01

    Objective Following traumatic brain injury (TBI),brain tissue that surrounding the regional primary lesion is known as traumatic penumbra; this region may undergo secondary injury and is considered to have the potential to recover.This review aimed to reveal the existence and significance of traumatic penumbra by analyzing all relevant studies concerning basic pathologic changes and brain imaging after TBI.Data sources We collected all relevant studies about TBI and traumatic penumbra in Medline (1995 to June 2013) and ISI (1997 to March 2013),evaluated their quality and relevance,then extracted and synthesized the information.Study selection We included all relevant studies concerning TBI and traumatic penumbra (there was no limitation of research design and article language) and excluded the duplicated articles.Results The crucial pathological changes after TBI include cerebral blood flow change,cerebral edema,blood-brain barrier damage,cell apoptosis and necrosis.Besides,traditional imaging method cannot characterize the consequences of CBF reduction at an early stage and provides limited insights into the underlying pathophysiology.While advanced imaging technique,such as diffusion tensor imaging (DTI) and positron emission tomography (PET),may provide better characterization of such pathophysiology.Conclusions The future of traumatic brain lesions depends to a large extent on the evolution of the penumbra.Therefore,understanding the formation and pathophysiologic process of the traumatic penumbra and its imaging research progress is of great significant for early clinical determination and timely brain rescue.

  17. Management of Blunt Trauma to the Spleen (Part 1

    Directory of Open Access Journals (Sweden)

    Seyed Abbas Banani

    2010-06-01

    Full Text Available AbstractSpleen is the most frequent solid organ to be injured in bluntabdominal trauma. Considering its important role in providingimmunity and preventing infection by a variety of mechanisms,every attempt should be made, if possible, to salvagethe traumatized spleen at any age particularly in children. Afterprimary resuscitation, mandatory requirements for nonoperativemanagement include absence of homodynamic instability,lack of associated major organ injury, admission inthe intensive care unit for high-grade splenic injury and in theward for milder types with close monitoring. About two thirdof the patients would respond to non-operative management.In most patients, failure of non-operative measures usuallyoccur within 12 hours of management. Determinant role ofabdominal sonography or computed tomography, and in selectedcases, diagnostic peritoneal lavage, for appropriate decisioncannot be overemphasized. However, the high status ofclinical judgment would not be replaced by any paraclinicalinvestigations. When operation is unavoidable, if possible,spleen saving procedures (splenorrhaphy or partial splenectomyshould be tried. In case of total splenectomy, autotransplantation,preferably in the omental pouch, may lead toreturn of immunity, at least partially, to prevent or reduce thechance of subsequent infection. Although total splenectomywith autograft is immunologically superior to total splenectomy-only procedure, these patients should also be protectedby vaccination and daily antibiotic for certain period of time.The essential steps for prevention of overwhelming infectionafter total splenectomy are not only immunization and administrationof daily antibiotic (up to 5 years of age or one year inolder children, but include education and information aboutthis dangerous complication. When non-operative managementis successful, the duration of activity restriction (inweeks is almost equal to the grade of splenic injury plus 2.Iran J Med Sci 2010

  18. Contrast-enhanced ultrasound (CEUS) in blunt abdominal trauma.

    Science.gov (United States)

    Miele, Vittorio; Piccolo, Claudia Lucia; Galluzzo, Michele; Ianniello, Stefania; Sessa, Barbara; Trinci, Margherita

    2016-05-01

    Baseline ultrasound is essential in the early assessment of patients with a huge haemoperitoneum undergoing an immediate abdominal surgery; nevertheless, even with a highly experienced operator, it is not sufficient to exclude parenchymal injuries. More recently, a new ultrasound technique using second generation contrast agents, named contrast-enhanced ultrasound (CEUS) has been developed. This technique allows all the vascular phase to be performed in real time, increasing ultrasound capability to detect parenchymal injuries, enhancing some qualitative findings, such as lesion extension, margins and its relationship with capsule and vessels. CEUS has been demonstrated to be almost as sensitive as contrast-enhanced CT in the detection of traumatic injuries in patients with low-energy isolated abdominal trauma, with levels of sensitivity and specificity up to 95%. Several studies demonstrated its ability to detect lesions occurring in the liver, spleen, pancreas and kidneys and also to recognize active bleeding as hyperechoic bands appearing as round or oval spots of variable size. Its role seems to be really relevant in paediatric patients, thus avoiding a routine exposure to ionizing radiation. Nevertheless, CEUS is strongly operator dependent, and it has some limitations, such as the cost of contrast media, lack of panoramicity, the difficulty to explore some deep regions and the poor ability to detect injuries to the urinary tract. On the other hand, it is timesaving, and it has several advantages, such as its portability, the safety of contrast agent, the lack to ionizing radiation exposure and therefore its repeatability, which allows follow-up of those traumas managed conservatively, especially in cases of fertile females and paediatric patients. PMID:26607647

  19. Post-traumatic bronchial mucus plug leading to pneumonectomy

    OpenAIRE

    Khan M. S.; Sarkar U. N

    2012-01-01

    Background: Blunt trauma of the chest is not uncommon these days. By far, the most important cause of significant blunt chest trauma is motor vehicle accidents. Pedestrians struck by vehicles, falls from height, blast injuries and acts of violence are other causative mechanisms. Most of the blunt trauma cases need no operative intervention and can be managed by supportive procedures. Aim: We present a case of a 10-year old boy who had blunt trauma to chest due to fall from height. Findings: T...

  20. Predicting outcomes after blunt chest wall trauma: development and external validation of a new prognostic model

    OpenAIRE

    Battle, Ceri Elisabeth; Hutchings, Hayley; Lovett, Simon; Bouamra, Omar; Jones, Sally; Sen, Aruni; Gagg, James; Robinson, David; Hartford-Beynon, Jake; Williams, Jeremy; Evans, Adrian

    2014-01-01

    Introduction Blunt chest wall trauma accounts for over 15% of all trauma admissions to Emergency Departments worldwide. Reported mortality rates vary between 4 and 60%. Management of this patient group is challenging as a result of the delayed on-set of complications. The aim of this study was to develop and validate a prognostic model that can be used to assist in the management of blunt chest wall trauma. Methods There were two distinct phases to the overall study; the development and the v...

  1. Non-operative versus operative treatment for blunt pancreatic trauma in children

    DEFF Research Database (Denmark)

    Haugaard, Michael V; Wettergren, André; Hillingsø, Jens Georg;

    2014-01-01

    or language of publication. DATA COLLECTION AND ANALYSIS: We used relevant search strategies to obtain the titles and abstracts of studies that were relevant for the review. Two review authors independently assessed trial eligibility. MAIN RESULTS: The search found 83 relevant references. We excluded...... all of the references and found no randomised clinical trials investigating treatment of blunt pancreatic trauma in children. AUTHORS' CONCLUSIONS: This review shows that strategies regarding non-operative versus operative treatment of severe blunt pancreatic trauma in children are not based on...

  2. An extension of the 'Malkus hypothesis' to the turbulent base flow of blunt sections

    Science.gov (United States)

    Vorus, William S.; Chen, Liyong

    1987-11-01

    An approximate theory for the mean turbulent near-wake of cylindrical bodies with blunt after edges is developed and implemented in terms of a linearized closed free-streamline theory of thin blunt-based symmetric sections. In the present application, the Malkus hypothesis leads to maximization of the rate of change of mean kinetic energy along the separation-cavity streamline. The results compare well with experimental measurements of mean base pressures and section drag, although the linearizing assumptions of section-cavity slenderness and base-pressure magnitude are not so well preserved in the calculated results.

  3. Thyroid gland rupture: a rare finding after a blunt neck trauma.

    Science.gov (United States)

    Zawawi, Faisal; Varshney, Rickul; Payne, Richard J; Manoukian, John J

    2013-05-01

    This is a case report of a 13 years old boy with a thyroid rupture secondary to a hockey stick blunt trauma to his neck and a literature review focused on diagnosis and management. There are 14 other cases in the literature, 7 of which required surgical intervention mainly to evacuate a hematoma. The case in this review did not develop any complications. This is the first reported case in the literature of thyroid gland rupture due to a blunt trauma in a child. Patients with thyroid gland rupture should be monitored closely for developing a hematoma or thyroid storm. PMID:23522054

  4. Liver injury following blunt abdominal trauma: a new mechanism-driven classification

    OpenAIRE

    Slotta, J. E.; Justinger, C.; Kollmar, O; Kollmar, C.; Schäfer, T.; Schilling, M. K.

    2013-01-01

    Purposes The current classifications for blunt liver trauma focus only on the extent of liver injury. However, these scores are independent from the localization of liver injury and mechanism of trauma. Methods The type of liver injury after blunt abdominal trauma was newly classified as type A when it was along the falciform ligament with involvement of segments IVa/b, III, or II, and type B when there was involvement of segments V–VIII. With the use of a prospectively established database, ...

  5. Surgical Management of Undiagnosed Laceration of Superior Vena Cava Caused by Blunt Trauma

    OpenAIRE

    Bouabdallaoui, Nadia; Debbagh, Hassan; Schoell, Thibaut; Lebreton, Guillaume

    2016-01-01

    International audience Intrapericardial rupture of the superior vena cava resulting from blunt thoracic trauma is a rare and life-threatening condition that has to be ruled out in the presence of signs of cardiac tamponade and a history of blunt thoracic trauma. We report the case of undiagnosed superior vena cava laceration caused by a high-speed road traffic accident in a 25 year-old patient revealed by cardiac tamponade. We highlight the need of urgent surgical exploration in all patien...

  6. Reynolds Number, Compressibility, and Leading-Edge Bluntness Effects on Delta-Wing Aerodynamics

    Science.gov (United States)

    Luckring, James M.

    2004-01-01

    An overview of Reynolds number, compressibility, and leading edge bluntness effects is presented for a 65 degree delta wing. The results of this study address both attached and vortex-flow aerodynamics and are based upon a unique data set obtained in the NASA-Langley National Transonic Facility (NTF) for i) Reynolds numbers ranging from conventional wind-tunnel to flight values, ii) Mach numbers ranging from subsonic to transonic speeds, and iii) leading-edge bluntness values that span practical slender wing applications. The data were obtained so as to isolate the subject effects and they present many challenges for Computational Fluid Dynamics (CFD) studies.

  7. Transonic Reynolds Number and Leading-Edge Bluntness Effects on a 65 deg Delta Wing

    Science.gov (United States)

    Luckring, J. M.

    2003-01-01

    A 65 degree delta wing has been tested in the National Transonic Facility (NTF) at mean aerodynamic chord Reynolds numbers from 6 million to 120 million at subsonic and transonic speeds. The configuration incorporated a systematic variation of the leading edge bluntness. The analysis for this paper is focused on the Reynolds number and bluntness effects at transonic speeds (M = 0.85) from this data set. The results show significant effects of both these parameters on the onset and progression of leading edge vortex separation.

  8. Reynolds Number and Leading-Edge Bluntness Effects on a 65 Deg Delta Wing

    Science.gov (United States)

    Luckring, J. M.

    2002-01-01

    A 65 deg delta wing has been tested in the National Transonic Facility (NTF) at mean aerodynamic chord Reynolds numbers from 6 million to 120 million at subsonic and transonic speeds. The configuration incorporated systematic variation of the leading edge bluntness. The analysis for this paper is focused on the Reynolds number and bluntness effects at subsonic speeds (M = 0.4) from this data set. The results show significant effects of both these parameters on the onset and progression of leading-edge vortex separation.

  9. Self-efficacy expectations among traumatized adolescents.

    Science.gov (United States)

    Saigh, P A; Mroueh, M; Zimmerman, B J; Fairbank, J A

    1995-07-01

    Bandura's Multidimensional Scales of Perceived Self-Efficacy (MSPSE) were administered to three matched groups of adolescents. The first group met diagnostic criteria for PTSD. The second had been exposed to qualitatively and quantitatively similar stressors and did not meet criteria for PTSD (traumatized PTSD negatives). The third group consisted of non-traumatized controls. Data analysis revealed that the adolescents with PTSD had appreciably lower self-efficacy ratings on eight of the nine subtests that comprise the MSPSE. Non-significant differences were observed when the MSPSE subtest scores of the traumatized PTSD negatives and controls were compared. PMID:7654163

  10. Scholastic impairments among traumatized adolescents.

    Science.gov (United States)

    Saigh, P A; Mroueh, M; Bremner, J D

    1997-05-01

    This investigation sought to determine if exposure to exceptional stress is associated with academic deficits or whether academic deficits are specifically associated with post-traumatic stress disorder (PTSD). In order to address these questions, the Metropolitan Achievement Test (MAT) as well as a measure of intelligence were administered to three groups of Lebanese adolescents. The first group met diagnostic criteria for PTSD. The second group had been exposed to qualitatively and quantitatively similar stressors but did not meet diagnostic criteria for PTSD. The third group consisted of nontraumatized controls. Data analysis using IQ as a covariate determined that the MAT scores of the PTSD subjects were significantly lower than the scores of the stress exposed PTSD negatives and controls. No significant differences were observed when the MAT scores of the stress exposed PTSD negatives and controls were compared. PMID:9149452

  11. Management of the Traumatized Airway.

    Science.gov (United States)

    Jain, Uday; McCunn, Maureen; Smith, Charles E; Pittet, Jean-Francois

    2016-01-01

    There is a lack of evidence-based approach regarding the best practice for airway management in patients with a traumatized airway. General recommendations for the management of the traumatized airway are summarized in table 5. Airway trauma may not be readily apparent, and its evaluation requires a high level of suspicion for airway disruption and compression. For patients with facial trauma, control of the airway may be significantly impacted by edema, bleeding, inability to clear secretions, loss of bony support, and difficulty with face mask ventilation. With the airway compression from neck swelling or hematoma, intubation attempts can further compromise the airway due to expanding hematoma. For patients with airway disruption, the goal is to pass the tube across the injured area without disrupting it or to insert the airway distal to the injury using a surgical approach. If airway injury is extensive, a surgical airway distal to the site of injury may be the best initial approach. Alternatively, if orotracheal intubation is chosen, spontaneous ventilation may be maintained or RSI may be performed. RSI is a common approach. Thus, some of the patients intubated may subsequently require tracheostomy. A stable patient with limited injuries may not require intubation but should be watched carefully for at least several hours. Because of a paucity of evidence-based data, the choice between these approaches and the techniques utilized is a clinical decision depending on the patient's condition, clinical setting, injuries to airway and other organs, and available personnel, expertise, and equipment. Inability to obtain a definitive airway is always an absolute indication for an emergency cricothyroidotomy or surgical tracheostomy. PMID:26517857

  12. Blunt abdominal trauma in adults: role of CT in the diagnosis and management of visceral injuries. Part 2: Gastrointestinal tract and retroperitoneal organs

    Energy Technology Data Exchange (ETDEWEB)

    Becker, C.D.; Terrier, F. [Department of Radiology, Division of Diagnostic and Interventional Radiology, Geneva University Hospital, 24, Rue Micheli-du-Crest, CH-1211 Geneva 14 (Switzerland); Mentha, G. [Department of Surgery, Division of Abdominal Surgery, Geneva University Hospital, 24, Rue Micheli-du-Crest, CH-1211 Geneva 14 (Switzerland); Schmidlin, F. [Department of Surgery, Division of Urology, Geneva University Hospital, 24, Rue Micheli-du-Crest, CH-1211 Geneva 14 (Switzerland)

    1998-06-02

    Computed tomography plays an important role in the detection and management of blunt visceral injuries in adults. Current standard examination techniques enable detection of the majority of perforating or devascularizing bowel injuries, although diagnostic findings are often subtle and meticulous inspection is required. Computed tomography may demonstrate pancreatic contusions and lacerations and help in distinguishing minor traumatic lesions without involvement of the pancreatic duct (organ injury scale, grades I and II) from deep lacerations with ductal involvement (grades III and V). Computed tomography enables distinguishing renal contusions and minor cortical lacerations that can usually be managed conservatively (injuries of grades I-III) from corticomedullary lacerations and injuries of the major renal vessels (grades IV and V) that have a less favorable prognosis and more commonly require surgical repair. In addition, CT is well suited for the detection of active renal hemorrhage and guidance of transcatheter embolization treatment and delineation of preexisting benign or malignant pathologies that may predispose to posttraumatic hemorrhage. The radiologist`s awareness of the diagnostic CT findings of abdominal visceral injuries as well as their clinical and surgical implications are important prerequisites for optimal patient management. (orig.) With 11 figs., 5 tabs., 56 refs.

  13. Blunt abdominal trauma in adults: role of CT in the diagnosis and management of visceral injuries. Part 2: Gastrointestinal tract and retroperitoneal organs

    International Nuclear Information System (INIS)

    Computed tomography plays an important role in the detection and management of blunt visceral injuries in adults. Current standard examination techniques enable detection of the majority of perforating or devascularizing bowel injuries, although diagnostic findings are often subtle and meticulous inspection is required. Computed tomography may demonstrate pancreatic contusions and lacerations and help in distinguishing minor traumatic lesions without involvement of the pancreatic duct (organ injury scale, grades I and II) from deep lacerations with ductal involvement (grades III and V). Computed tomography enables distinguishing renal contusions and minor cortical lacerations that can usually be managed conservatively (injuries of grades I-III) from corticomedullary lacerations and injuries of the major renal vessels (grades IV and V) that have a less favorable prognosis and more commonly require surgical repair. In addition, CT is well suited for the detection of active renal hemorrhage and guidance of transcatheter embolization treatment and delineation of preexisting benign or malignant pathologies that may predispose to posttraumatic hemorrhage. The radiologist's awareness of the diagnostic CT findings of abdominal visceral injuries as well as their clinical and surgical implications are important prerequisites for optimal patient management. (orig.)

  14. Effect of different duration of pericardial catheter drainage on the outcome of lung cancer patients with malignant pericardial effusion%心包置管引流时间对肺癌心包转移疗效的影响

    Institute of Scientific and Technical Information of China (English)

    都彩菊; 刘效波; 李献兵

    2011-01-01

    Objective To evaluate the early effects and safety of prolonged implanted catheter in pericardium on the patients with lung cancer and pericardial transmission. Methods Eighty-eight cases enrolled were randomly devided into two groups(group A and group B),the period of implanted catheter was more than four weeks in group A and less than four weeks in group B. The treatment protocal of the two groups was the same, then to observe the outcome, survival time of patients, the recurrence rate of pericardial effusion, the complications relevant to the catheter. Results The early complete relief rate (CRR) of two groups(A and B) was of no statistical significance (χ2=2.93,P=0.09), but the total effective rate of two groups had a significant statistical difference(90.91% vs 70.45%,χ2=5.91,P=0.02), OR=4.19, 95%CI(confidence interval):1.24-14.13. The recurrence rate of two groups within half a year was 20.45% vs 38.63%,χ2=3.91,P=0.04,the survival rate of group A and group B was 72.47% and 51.38%(Log rank=4.76,P=0.04).The median survival period of two groups within half a year was 7.96 months and 3.52 months. There were no difference in complication(4.55% vs 2.77%,χ2=0.34,P>0.05),and there were not pyogenic infection in pericardium, fistula formation, penicarditis severe pericardiosymphysis and myocardial injury. Conclusions The moderate prolonged time of catheter drainage treatment is an effective and safe approach for lung cancer patients with pericardial transmission, it can be the main treatment.%目的 探讨不同心包内置管引流时间对肺癌伴恶性心包积液心包填塞的临床疗效和安全性.方法 将入选的88例患者随机分为A、B两组.A组44例,为长时间置管组,置管时间为>4周;B组44例,为短期置管组,置管时间<4周.两组患者均接受相同的心包注射和全身静脉注射药物治疗方案,分别观察6个月内的疗效、生存时间、复发率、生存率及置管并发症发生率.结果 A

  15. Nonsurgical interventions after mild traumatic brain injury

    DEFF Research Database (Denmark)

    Nygren-de Boussard, Catharina; Holm, Lena W; Cancelliere, Carol;

    2014-01-01

    OBJECTIVE: To synthesize the best available evidence regarding the impact of nonsurgical interventions on persistent symptoms after mild traumatic brain injury (MTBI). DATA SOURCES: MEDLINE and other databases were searched (2001-2012) with terms including "rehabilitation." Inclusion criteria were...

  16. Magnetic Resonance Imaging for Traumatic Knee Injury

    OpenAIRE

    Oei, Edwin

    2009-01-01

    textabstractTraumatic knee lesions are frequently encountered both in general practice and in the hospital setting. These injuries are often caused by sports and other physical activities and may lead to severe pain and disability.

  17. Postpartum Post-Traumatic Stress Disorder

    Science.gov (United States)

    ... with PSI Learn More Pregnancy & Postpartum Mental Health Depression During Pregnancy & Postpartum Anxiety During Pregnancy & Postpartum Pregnancy or Postpartum Obsessive Symptoms Postpartum Post-Traumatic Stress Disorder Bipolar Mood Disorders Postpartum Psychosis Tools for ...

  18. Traumatic brain injury-induced sleep disorders.

    Science.gov (United States)

    Viola-Saltzman, Mari; Musleh, Camelia

    2016-01-01

    Sleep disturbances are frequently identified following traumatic brain injury, affecting 30%-70% of persons, and often occur after mild head injury. Insomnia, fatigue, and sleepiness are the most frequent sleep complaints after traumatic brain injury. Sleep apnea, narcolepsy, periodic limb movement disorder, and parasomnias may also occur after a head injury. In addition, depression, anxiety, and pain are common brain injury comorbidities with significant influence on sleep quality. Two types of traumatic brain injury that may negatively impact sleep are acceleration/deceleration injuries causing generalized brain damage and contact injuries causing focal brain damage. Polysomnography, multiple sleep latency testing, and/or actigraphy may be utilized to diagnose sleep disorders after a head injury. Depending on the disorder, treatment may include the use of medications, positive airway pressure, and/or behavioral modifications. Unfortunately, the treatment of sleep disorders associated with traumatic brain injury may not improve neuropsychological function or sleepiness. PMID:26929626

  19. TRAUMATIC BRAIN INJURY SURVEILLANCE SYSTEM (TBISS)

    Science.gov (United States)

    The National Center for Injury Prevention and Control (NCIPC), Centers for Disease Control and Prevention (CDC) had developed and maintains a surveillance system to understand the magnitude and characteristics of hospitalized and fatal traumatic brain injuries in the United State...

  20. Comparison of immersion ultrasonography, ultrasound biomicroscopy and anterior segment optical coherence tomography in the evaluation of traumatic phacoceles

    Directory of Open Access Journals (Sweden)

    Harikrishna Vodapalli

    2012-01-01

    Full Text Available Blunt ocular trauma in the elderly can result in anterior dislocation of the crystalline lens into the subconjunctival space (phacocele. Although rare, this presentation can be missed, especially if the patient presents several days after the injury and if the lid is not everted on examination. While a careful clinical examination is adequate in the diagnosis, imaging techniques can be put to use for the accurate location of the associated sclera rupture. We report three cases of post-traumatic phacocele wherein ultrasound biomicroscopy (UBM was compared to the anterior segment optical coherence tomography (AS-OCT and B-scan ultrasonography (B-scan, in order to establish the best imaging tool for this condition. We concluded, based on image quality, that UBM could be the imaging modality of choice to aid in the diagnosis of phacocele.