摘要:

We report two cases of missed diaphragmatic injury which were diagnosed and repaired using a thoracoscopic approach. A right diaphragmatic injury sustained via a stab wound to the chest was diagnosed and repaired thoracoscopically using a stapling technique. A second patient sustained an injury to the right diaphragm from a gunshot wound, which was sutured thoracoscopically. Both patients recovered uneventfully and had shortened hospital stays in spite of the nature of their injury and initial delay in diagnosis. With the increase in unsuspected diaphragmtic injuries being reported, we feel that combined thoracoscopy and laparoscopy may offer a therapeutic as well as dignostic benefit in selected stable patients with penetrating injuries to the upper abdomen and lower chest. Although this initial report is encouraging, further investigation is needed to determine optimal patient selection criteria as well as the cost-effectiveness of this approach.

ISSN:0022-5282    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A case is presented of unilateral traumatic massive air leak successfully treated with prolonged double-lumen endobronchial intubation and unilateral high frequency intermittent positive pressure ventilation, while the “good” lung was ventilated conventionally. The problems encountered are described and the rationale for this management are discussed.

ISSN:0022-5282    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Blunt thoracic aortic injury most often occrs beyond the left subclavian artery with subsequent transection and exsanguination. We present a case of an unrestrained driver involved in a high-speed motor vehicle crash who had a traumatic mid-thoracic aortic dissection involving the orifices of both renal arteries, resulting in anuria. This diagnosis should be considered in the presence of anuria following chest trauma.

ISSN:0022-5282    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A young farmer was disabled by chronic pain for more than one year from a free intrapleural missile. Radiologic evidence of missile immobility and the tendency to observe chronically embedded missiles led to a delay in diagnosis. Intrapleural foreign bodies need to be considered in the evaluation of pain following chest or upper abdominal gunshot wounds.

ISSN:0022-5282    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Computed tomogrpahy is considered a reliable imaging technique when determining the extent of splenic injury. We present the case of a patient with a traumatic infarct of the spleen detected by computed tomogrpahic scanning of the abdomen. During laparotomy there was an infarction of the spleen from a hilar injury in addition to bleeding from the splenic vein. We conclude that ongoing bleeding from the splenic hilar vessel can lead to a rim of enhancement around the spleen from contrast material. This should be taken into account when a decision is made for nonsurgical management.

ISSN:0022-5282    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Traumatic abdominal wall hernia (TAWH) is an uncommon injury. Handlebar hernia represents one type of TAWH: handlebar hernia is caused by low-energy impact against a small blunt object, can be detected by physical examination is infrequently associated with other significant injury. Surgical repair is recommended.

ISSN:0022-5282    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

To our knowledge, no case of occipital condyle fracture after minor head trauma in the pediatric population has been published. We report the case of a 12-year-old girl with a Jefferson's fracture detected on x-ray films. Axial high resolution computed tomography and coronal reconstruction images demonstrated the additional occipital condyle fracture.

ISSN:0022-5282    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Multiple injuries of iliac veins are uncommon and frequently fatal. An unusual case in which there were injuries of the four iliac veins by gunshot is described. Prompt control of hemorrhage is required. Because our patient was in unstable condition, ligation of the four iliac veins was performed and the abdomen was packed. After a complicated course, the patient was discharged after 40 days in good condition. Although venous repair is often recommended, ligation in extensive injuries may be necessary is usually well tolerated in young, previously healthy individuals like our patient.

ISSN:0022-5282    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Avulsion of the anterior-superior iliac spine rarely occurs in adolescents. The condition is commonly encountered in athletes. Despite the resulting caudal dislocation of the apophysis, the injury is as a rule treated by conservative means. We report on avulsion in two young athletes treated by open reduction and internal fixation, which enabled them to resume sports: one 3 weeks and the other 4 weeks after the injury. Treatment by open reduction and internal fixation is also indicated in patients requiring a short convalescence.

ISSN:0022-5282    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A 51-year-old woman was involved in a motor vehicle crash, sustaining multiple injuries including a longitudinal displaced burst fracture of the sacrum associated with neurologic deficits and fractures of the pelvis. A computed tomographic scan was valuable in properly identifying of the pelvis. A computed tomographic scan was valuable in properly identifying the extent of the sacral fracture. Because of the neurologic deficits and displacement of the sacral fracture and fixation of the pelvic fracture were performed. The patient's neurologic deficits improved at last follow-up examination she was ambulating without assistance.

ISSN:0022-5282    

出版商:OVID    

年代:1994

数据来源: OVID