1/72. Acute pseudohepatitis in a chronic substance abuser secondary to occult seat belt injury.Causes of a massive elevation in serum aminotransferases (aspartate aminotransferase [AST] and alanine aminotransferase [ALT]) in the substance-abusing patient include viral hepatitis and drug hepatotoxicity. A patient chronically addicted to injection heroin and cocaine presented to the emergency room in a confused state and was admitted to a medical ward with an AST of 4120 U/L, ALT 3820 U/L and right upper quadrant discomfort. Investigations for viral and hepatotoxic causes for the liver dysfunction revealed only hepatitis c seropositivity. A computed tomogram of the abdomen, however, revealed a significant contusion to the right lobe of the liver consistent with traumatic injury. A motor vehicle accident, in which the patient was wearing a seat belt, and which had occurred a few days before admission and had been thought to be minor, was the cause of the liver dysfunction. Significant blunt abdominal traumatic injuries are usually managed exclusively by surgical trauma units. This case underlines the need for medical specialists to be aware of hepatic contusion injuries and to have a high index of suspicion when investigating unexplained hepatocellular dysfunction in chronic substance abusers who have been in motor vehicle accidents.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
2/72. Dorsal compartment syndrome of the upper arm. A case report.A rare case of posttraumatic dorsal compartment syndrome of the upper arm is reported. This case was diagnosed by measuring the intracompartmental pressure. The patient was administered local anesthesia and immediately underwent surgery. The result was successful.- - - - - - - - - - ranking = 5keywords = upper (Clic here for more details about this article) |
3/72. Contusion of lungs.A 16 years old male with history of beating by army personnel was admitted in the hospital with the complaints of chest pain and breathlessness. After about 5 hours of admission, the patient died in spite of treatment with analgesics, antibiotics, fluids and oxygen inhalation. The autopsy report showed multiple bruises on different body parts and there were contusions on the lungs showing impression of rib patterns. Histological examination showed alveoli filled with blood and cellular infiltrate in interalveolar and interstitial spaces.- - - - - - - - - - ranking = 158.93522593784keywords = chest, pain (Clic here for more details about this article) |
4/72. Tumoral calcinosis: a case report with an electron microscopic study.A 68-year-old woman developed large subcutaneous masses on her abdomen and thighs after a bruise sustained in a traffic accident. She had severe pain when sitting up straight. Histological examination revealed calcified tissues in the entire dermis of the injured areas. On electron microscopy, crystalline materials were observed in the dermis, which seemed to be formed by the deposition of hydroxyapatite on unusual proteoglycan. In a vessel wall, a thick, layered basement membrane was observed. This suggests that vascular injury and subsequent hypoxia play a role in the process of calcinosis. We performed a partial resection with good results in alleviating the patient's pain.- - - - - - - - - - ranking = 7.0756499949393keywords = pain (Clic here for more details about this article) |
5/72. Cardiac contusion: two case vignettes.When patients with blunt chest trauma and suspected cardiac contusion are brought to the emergency department, focus on detecting subtle signs of myocardial dysfunction. Obtain the important first EKG, monitor for arrhythmia development, and assess for signs of failure of the right side of the heart.- - - - - - - - - - ranking = 155.39740094037keywords = chest (Clic here for more details about this article) |
6/72. scurvy presenting as painful gait with bruising in a young boy.A case of scurvy occurred in an apparently well-nourished 5-year-old boy with normal growth parameters. Only after the diagnosis of scurvy was raised on clinical grounds did we discover the peculiar dietary habits that were responsible for his deficiency of ascorbic acid. His case is a reminder to the clinician that nutritionally based disease may occur in any socioeconomic setting and that nutritional screening remains an important part of every child's general health care.- - - - - - - - - - ranking = 14.151299989879keywords = pain (Clic here for more details about this article) |
7/72. Late cardiac arrhythmias after blunt chest trauma.OBJECTIVE: case reports of two patients who developed fatal cardiac arrhythmias several days after blunt chest trauma. DESIGN: case reports. SETTING: Surgical intensive care unit of a university hospital. patients: A 23-year-old man and a 9-year-old girl with blunt chest trauma and multiple further injuries following car crashes were transferred to our institution. Although ECG on admission was normal, both patients developed fatal cardiac arrhythmias after 6 and 4 days, respectively. In both patients, post-mortem analysis confirmed myocardial contusion without coronary artery lesions. Histological findings included severe interstitial oedema, haemorrhages and infiltration of lymphocytes and neutrophils, fresh myocardial necrosis and fatty degeneration. CONCLUSION: Blunt chest trauma with myocardial contusion may lead to fatal cardiac arrhythmias even after several days, particularly when other severe injuries are present. Thus, a normal ECG on admission and absence of cardiac arrhythmias during the first 24 h of intensive care treatment do not necessarily exclude the occurrence of life-threatening arrhythmias in the further course.- - - - - - - - - - ranking = 1087.7818065826keywords = chest (Clic here for more details about this article) |
8/72. Bone bruise of the calcaneus. A case report.A bone bruise to both calcanei after axial overloading is reported. Because radiographs were normal and weightbearing was not possible, magnetic resonance imaging was performed and showed characteristic findings for a bone bruise of the calcaneus more extended on the left side than the right side. Resolution of pain was within the first 2 weeks after trauma on the right side, whereas partial weightbearing was necessary for 4 months on the left side. Six months after trauma, complete resolution of magnetic resonance signal changes was evident. Bone bruises should be considered when radiographs are normal. Because bone bruises pose a potential risk for chondrolysis and stress fracture, mobilization and weightbearing should be increased gradually.- - - - - - - - - - ranking = 3.5378249974696keywords = pain (Clic here for more details about this article) |
9/72. Blunt chest trauma: review of selected pulmonary injuries focusing on pulmonary contusion.Pulmonary injuries resulting from blunt chest trauma remain a common clinical entity for critical care and emergency nurses. In this article, the epidemiology and mechanism of injury most often observed in patients with blunt chest trauma are reviewed. Selected pulmonary injuries are discussed in terms of mechanism of injuries, assessment and diagnostic modalities, standard therapies, and cutting-edge therapies used today with a focus on pulmonary contusion. Many advances and experimental therapies currently used in the management of the patient with severe lung injuries are discussed. A case study is presented highlighting a complicated case of a blunt chest injury resulting in severe pulmonary contusion.- - - - - - - - - - ranking = 1087.7818065826keywords = chest (Clic here for more details about this article) |
10/72. Aortic dissection and rupture presenting as suprasternal bruising and neck swelling.BACKGROUND: a 76-year-old man presented with transient loss of consciousness associated with swelling of the neck, bruising in the suprasternal notch and an absent left carotid pulse. blood pressure was equal in both arms and chest x-ray was normal, but computed tomography of the neck and thorax showed dissection and rupture of the thoracic aorta with extensive intra-mediastinal bleeding. OUTCOME: surgical intervention was inappropriate in this situation and the patient died within 4 hours of presentation. CONCLUSION: syncope is a common presentation to hospital in older people and its cause may be difficult to elucidate, particularly if the patient is unable to provide a reliable history. syncope without pain is a rare presentation of aortic dissection and the occurrence of anterior chest wall bruising has not been described previously. pulse deficits and abnormal chest x-ray findings are often cited as indicative of aortic dissection but are rare manifestations and their absence should not be used to exclude this diagnosis.- - - - - - - - - - ranking = 469.73002781859keywords = chest, pain (Clic here for more details about this article) |
| | Next -> |