11/123. The occurrence of a strangulated ileus due to a traumatic transmesenteric hernia: report of a case.We report herein the case of a 6-year-old boy in whom a strangulated ileus was caused by a traumatic transmesenteric hernia. The boy had fallen from his bicycle and suffered a severe blow to the abdomen. abdominal pain and vomiting developed 10 h after the accident and he was admitted to our hospital. Abdominal ultrasonogram and computed tomogram demonstrated ascites, intestinal wall thickening with fluid, and an engorged radiating mesenteric vasculature. Thus, an emergency laparotomy was performed which revealed bloody ascites, a strangulated ileus, and torsion with a transmesenteric hernia. The necrotic intestine was resected and an anastomosis was performed. Macroscopic and microscopic findings revealed a traumatic mesenteric rent. The unusual presentation of this case is discussed.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
12/123. Traumatic avulsion of kidney into the chest through a ruptured diaphragm in a boy.This report presents a case of a teenage patient who survived following severe blunt trauma with complete avulsion of the right kidney into the chest through a ruptured diaphragm. The combination of kidney avulsion into the chest is extremely rare. Only three similar cases have been reported in the English literature to date (1-3).- - - - - - - - - - ranking = 9.5827920406261keywords = chest (Clic here for more details about this article) |
13/123. Serial bedside emergency ultrasound in a case of pediatric blunt abdominal trauma with severe abdominal pain.We present a case of a teenager with isolated left renal laceration with perirenal hematoma. The patient had presented with severe left upper quadrant (LUQ) pain following blunt abdominal trauma (BAT) sustained during a sledding accident. A screening bedside focused abdominal sonogram for trauma (FAST) rapidly excluded free fluid on two serial examinations, 30 minutes apart. It provided the pediatric emergency physician with a measure of diagnostic confidence that the patient could be safely transported to the CT suite for detailed delineation of his injury. Moreover, narcotic analgesia was liberally administered early in his illness course, without the fear of unmasking potential hypovolemia when it was known that he did not have gross intra-abdominal bleeding on his bedside ultrasound (US). It also provided a working diagnosis of the primary organ of injury. Our hospital, like many pediatric hospitals around the nation, does not have in-house 24-hour radiology support. We suggest that the use of the bedside US be extended to the stable pediatric patient in severe abdominal pain following BAT. It can serve as a valuable, rapid, noninvasive, bedside, easily repeated, fairly accurate triage tool to evaluate pediatric BAT with severe pain.- - - - - - - - - - ranking = 75.646579106869keywords = abdominal pain, pain (Clic here for more details about this article) |
14/123. Blunt abdominal trauma with delayed rupture of splenic haematoma in a haemophiliac patient.A 13-year-old haemophilia A patient presented with pain in the abdomen, 4 days after a blunt abdominal trauma. The computed tomography scan of the abdomen showed a large splenic haematoma. The patient was initially managed with factor viii replacement therapy, but 4 weeks later he had a delayed rupture of the splenic haematoma with haemoperitoneum and shock. An elective splenectomy under factor viii therapy was successfully performed.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
15/123. suicide by hara-kiri: a series of four cases.The authors describe four cases of suicide by hara-kiri. This very painful form of suicide consists of self-inflicting a wound in the abdomen using a sharp instrument. It was first reported in 988 A.D. in the East but has now become rare in both the East and West. These four cases occurred over a 40-year period in the Trieste and Bari medicolegal area. In two of our cases the victims were afflicted with mental illness, whereas the other two suffered from depression. In cases of death by hara-kiri, it is important to establish a differential diagnosis between suicide and homicide; the presence of trial wounds (inflicted by the victim as a form of practice to overcome any hesitation before stabbing the abdomen with the cutting weapon) can prove very helpful.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
16/123. delayed diagnosis of cardiac tamponade following isolated blunt abdominal trauma.Traumatic haemopericardium is an uncommon but life threatening condition. It is usually caused by penetrating cardiac injuries or cardiac rupture from blunt chest trauma. We report haemopericardium and cardiac tamponade in a young girl after blunt abdominal trauma. She presented with mild upper abdominal pain, tachycardia and hypotension having been kicked in the abdomen by a horse. No damage was found at laparotomy and she remained haemodynamically unstable. Further investigation found cardiac tamponade and haemopericardium. This was managed by insertion of a pericardial drain using transthoracic echocardiogram guidance, with later drainage in the operating theatre using guidance with a transoesophageal echocardiogram.- - - - - - - - - - ranking = 16.326447828145keywords = abdominal pain, chest, pain (Clic here for more details about this article) |
17/123. abdominal pain in a child after blunt abdominal trauma: an unusual injury.We report a case of perforation of a walled off appendiceal abscess in a 5-year-old boy who sustained blunt abdominal trauma. The past medical history was significant only for a 4-day episode of abdominal pain 1 month prior to this presentation. Initial laboratory studies were unremarkable, and radiographic studies showed free fluid in the pelvis with no evidence of solid organ injury, but inflammation of the right colon. The final diagnosis was made at laparotomy. We emphasize this unique presentation and review the literature on traumatic appendicitis in children.- - - - - - - - - - ranking = 18.729315821374keywords = abdominal pain, pain (Clic here for more details about this article) |
18/123. Seat-belt syndrome revisited.This report describes a complex syndrome of injuries occurring in a young female who was a back seat passenger wearing a lap-belt restraint in a high-speed road traffic accident. As a consequence of the forced flexion distraction injury of her lumbar spine, she sustained a fracture-subluxation of the first lumbar vertebra in association with a jejunal perforation and extensive small intestinal mesenteric laceration. She also had a large traumatic hernia of the anterior abdominal wall, which was overlooked at primary laparotomy. This report highlights collectively the classical combination of injuries associated with the lap-belt syndrome and demonstrates the importance of carefully inspecting the anterior abdominal wall for deficiencies, because traumatic herniation may be easily overlooked.- - - - - - - - - - ranking = 0.12165468912591keywords = back (Clic here for more details about this article) |
19/123. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Detection of pneumoperitoneum on erect chest radiograph.A short cut review was carried out to establish whether a normal erect chest radiograph excludes the diagnosis of perforated abdominal viscus. Altogether 37 papers were found using the reported search, of which two presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are shown in table 1. A clinical bottom line is stated.- - - - - - - - - - ranking = 14.374188060939keywords = chest (Clic here for more details about this article) |
20/123. Isolated rupture of an accessory liver from blunt abdominal trauma in childhood.An accessory liver is uncommonly encountered in surgical practice. It can rarely cause acute abdominal pain. An isolated injury to an accessory liver from blunt trauma in a 10-year-old boy caused major intraperitoneal haemorrhage. laparotomy and excision of the lacerated accessory liver lobe was necessary; the patient recovered uneventfully. The literature on accessory liver is reviewed.- - - - - - - - - - ranking = 14.729315821374keywords = abdominal pain, pain (Clic here for more details about this article) |
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