1/102. On scene thoracotomy: a case report.We report a case of on scene resuscitative thoracotomy performed by an anaesthetist on a patient in cardiac arrest following a stab wound to the chest. The patient made a good recovery and was discharged from hospital within 2 weeks. The rationale for performing resuscitative thoracotomy and who should perform this procedure are discussed.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
2/102. An unusual case of suicide by stabbing with a falling weighted dagger.An unusual suicide by self-stabbing is presented. A 42-year-old man committed suicide with a dagger weighted with 2.72 kg in total and allowed to fall freely. The blade of the dagger fell from a height of 10 cm above the chest, penetrated the second left intercostal skin and pierced the upper lobe of the left lung. However, the weapon did not penetrate the chest skin from a stationary position in our trial at the autopsy. This finding confirms the results of experiments with stab wound dynamics which demonstrated that the impact velocity of the weapon as well as the sharpness of the tip is important for skin penetration.- - - - - - - - - - ranking = 2keywords = chest (Clic here for more details about this article) |
3/102. Forensic echocardiography: a case in point.Transthoracic echocardiography (TTE) has an important role in the assessment of patients with acute penetrating chest trauma. We report the case of a 36-year-old man who sustained a stab wound to the chest. After admission, he required emergency pericardiocentesis. TTE revealed a traumatic ventricular septal defect and a defect in the anterior mitral valve leaflet. To assess whether these lesions were related to the initial stab wound or the pericardiocentesis, the transducer was positioned over the stab wound, and the lesions were shown to be in the same plane as the entry site, thus ruling out iatrogenic trauma.- - - - - - - - - - ranking = 2keywords = chest (Clic here for more details about this article) |
4/102. Lung isolation for the prevention of air embolism in penetrating lung trauma. A case report.PURPOSE: To illustrate a new airway and ventilatory management strategy for patients with unilateral penetrating lung injury. Emphasis is placed on avoiding positive pressure ventilation (PPV)-induced systemic air/gas embolism (SAE) through traumatic bronchiole-pulmonary venous fistulas. CLINICAL FEATURES: A 14-yr-old male, stabbed in the left chest, presented with hypovolemia, left hemopneumothorax, an equivocal acute abdomen, and no cardiac or neurological injury. In view of the risk of SAE, we did not ventilate the left lung until any fistulas, if present, had been excised. After pre-oxygenation, general anesthesia was induced and a left-sided double-lumen tube (DLT) was placed to allow right-lung ventilation. bronchoscopy was performed. The surgeons performed a thorascopic wedge resection of the lacerated lingula. Upon completion of the repair, two-lung ventilation was instituted while the ECG, pulse oximetry, PETCO2, and blood pressure were monitored. Peak inflation pressure was increased slowly and was well tolerated up to 50 cm H2O. The patient's intravascular status was maintained normal. CONCLUSION: patients with lung trauma are at risk of developing SAE when their lungs are ventilated with PPV. In a unilateral case, expectant non-ventilation of the injured lung until after repair is recommended.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
5/102. 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 = 6keywords = chest (Clic here for more details about this article) |
6/102. 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 = 5keywords = chest (Clic here for more details about this article) |
7/102. 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 = 1keywords = chest (Clic here for more details about this article) |
8/102. 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 = 1keywords = chest (Clic here for more details about this article) |
9/102. 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 = 6keywords = chest (Clic here for more details about this article) |
10/102. Delayed cardiac tamponade after coronary artery laceration.Delayed cardiac tamponade after laceration of a coronary artery is unusual and uncommonly reported in the literature. We describe a patient in whom this potentially fatal complication developed 8 days after a stab wound to his chest. In our review of the English language literature we identified only one other report of delayed tamponade after coronary artery laceration.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
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