11/151. A chest injury in an isolated geo-politically sensitive area: questions in management.The reported case of a stab wound to the chest occurred in an isolated area with no specialized surgical care available. The need for transport and specifically by air, introduced particular questions in management. On a humanitarian basis and in line with its mandate, the Peace Monitoring Group, a united nations endorsed entity in Bougainville, papua new guinea, provided transport to a facility with an appropriate standard of care. The questions of need for patient evacuation and chest drainage, with the timing of this maneuver are considered.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
12/151. 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 = 0.0014572509806539keywords = pain (Clic here for more details about this article) |
13/151. Traditional punishment and unexpected death in Central australia.Three cases of traditional punishment in Central Australian Aboriginal men are presented in which the thighs were speared or stabbed as part of a "payback" system. In two cases, an unexpected effect of the stabbing or spearing was death due to severing of major leg vessels. The relationship between customary Aboriginal law and general law in australia has not been clearly defined; however, these cases demonstrate that significant and untoward effects may result from traditional punishments. Pathologists working near traditional Australian Aboriginal communities may still encounter such injuries at autopsy.- - - - - - - - - - ranking = 0.013003504238686keywords = back (Clic here for more details about this article) |
14/151. Mesenteric ischemia: an unusual presentation of traumatic intrahepatic arterioportal fistula.Traumatic hepatic arterioportal fistulae (APF) are described infrequently as sequelae of hepatic trauma. These anomalies are usually associated with blunt hepatic trauma or iatrogenic injury. The majority of APF present within weeks to months of injury with gastrointestinal hemorrhage, hemobilia, abdominal pain, and diarrhea. When presenting remotely APFs are associated with portal hypertension, heart failure, gastrointestinal hemorrhage, ascites, and splenomegaly. We report an unusual case of mesenteric ischemia due to an APF that resulted from a penetrating liver injury 20 years before presentation. Successful treatment of the APF was achieved by intravascular catheter occlusion resulting in resolution of symptoms.- - - - - - - - - - ranking = 0.0014572509806539keywords = pain (Clic here for more details about this article) |
15/151. Unusual stab wound of the temporal region.We report the case of an unusual penetrating injury of the temporal region of the head caused by knife. A long kitchen knife was protruding from the upper auricular area of the left temporal region of victims head. It cut through the posterosuperior part of the left auricula and remained fixed to the postauricular region. brain computorized tomography (CT) scan revealed that the knife had reached deep into the petrous part of the temporal bone, and was directed toward the sulcus of the sigmoid sinus. There were no signs of intracranial bleeding. An otorhinolaryngologist and a neurosurgeon removed the knife in operating room, with the patient in general anesthesia. The audiogram obtained after 7 days of hospitalization showed left conductive hearing loss of 40 dB at frequencies up to 2 kHz, and of 90 dB above 2 kHz, probably due to hemotympanum caused by the operation. Control examinations performed 14 days and one month after discharge confirmed the patients complete recovery and no significant defects in his hearing or balance. We suggest multidisciplinary teamwork as a proper approach in the treatment of such injuries.- - - - - - - - - - ranking = 0.0028480049567824keywords = upper (Clic here for more details about this article) |
16/151. Endovascular repair of occluded subclavian arteries following penetrating trauma.PURPOSE: To describe the endovascular repair of 2 subclavian arteries occluded due to penetrating trauma. case reports: Two male patients were admitted with zone-I neck stab wounds. Both were hemodynamically stable and had absent pulses in the ipsilateral upper limb with decreased Doppler pressures. There were no signs of critical ischemia or active bleeding. On arteriography, complete occlusion of the second segment of the left subclavian arteries in both patients was demonstrated. Stent-graft repair and embolectomy under local anesthesia were successfully performed. No procedure-related complications occurred, and both patients were discharged after 2 days. At 1-year follow-up, stent-graft patency was demonstrated in both patients. CONCLUSIONS: Endovascular repair is a feasible and safe option in the management of occluded subclavian arteries due to penetrating trauma. This may represent another indication for stent-grafting in the expanding role of this technique.- - - - - - - - - - ranking = 0.0028480049567824keywords = upper (Clic here for more details about this article) |
17/151. Traumatic diaphragmatic hernia presenting as a tension fecopneumothorax.Diaphragmatic injury with accompanying hernia is a well-documented complication associated with both penetrating and blunt trauma. It occurs in approximately 3% of abdominal injuries with a 2:1 ratio of penetrating to blunt trauma. diagnosis requires a high index of suspicion since diaphragmatic injury can only reliably be ruled out by direct visualization, i.e., laparoscopy. Hence, delayed presentation with complications secondary to the injury is not uncommon. We discuss a case of a young man who presented in respiratory distress six years after a stab wound to the left chest. The patient was hypoxic, with a chest X-ray (CXR) demonstrating a pneumothorax with effusion. A chest tube was placed with a rush of air and foul-smelling purulent drainage. work-up revealed incarcerated transverse colon in a diaphragmatic hernia. Celiotomy demonstrated necrotic colon in the chest with gross fecal contamination in both the chest and abdomen. The diaphragmatic defect was closed and a Hartmann's procedure performed. The patient did well postoperatively except for the development of an empyema, which resolved with conservative management. Our patient is the eleventh reported case of a tension fecopneumothorax resulting from traumatic diaphragmatic herniation. This paper reviews all cases including the diagnostic work-up, operative approach, and ex ected postoperative course of this unusual condition.- - - - - - - - - - ranking = 0.83333333333333keywords = chest (Clic here for more details about this article) |
18/151. suicide by more than 90 stab wounds including perforation of the skull.A man committed suicide in his bathroom using a small pocket knife. At the autopsy a total of 92 stab wounds on the forehead, in both temples, the anterior aspect of the neck, the back of the neck, the chest and the sides of the trunk were found. In addition, repeated stabbing had caused a large soft tissue defect on the forehead. The frontal bone showed 3 perforations but no brain injury was present and two ribs were severed in the bony part, one of which carried a star-like pattern from repeated stabbing. No major vessels were injured and the cause of death was exsanguination after a considerable survival time. The large number of stab wounds, the perforation of bone and some injury sites, especially the head and back of the neck, are extraordinary findings in suicides which were probably favoured by insufficient anatomical knowledge and the use of a short-bladed knife. A psychiatric history could not be verified.- - - - - - - - - - ranking = 0.19267367514404keywords = chest, back (Clic here for more details about this article) |
19/151. Traumatic pulmonary arteriovenous fistula.The first case of traumatic pulmonary arteriovenous fistula in the English literature is reported. The case is reported to alert thoracic surgeons to the possibility of this lesion following penetrating chest injuries.- - - - - - - - - - ranking = 0.16666666666667keywords = chest (Clic here for more details about this article) |
20/151. Traumatic ventricular septal defect and mitral insufficiency after a Kebab's shish wound to the chest.Transthoracic echocardiography has an important role in the assessment of patients with penetrating chest trauma. We report the case of 19-year-old boy who sustained a kebab's shish wound to the chest. Transthoracic echocardiography revealed a defect in the interventricular septum and a defect in the anterior mitral valve. Both of them were closed with direct sutures.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
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