1/18. An aneurysm involving the axillary artery and its branch vessels in a major league baseball pitcher. A case report and review of the literature.baseball pitchers appear to be prone to aneurysms of the axillary artery and its branches. The cause is probably related to repetitive compression of or tension on the vessels at the level of the pectoralis minor muscle and the humeral head, which is exacerbated by the pitching motion. The incidence of aneurysms of the axillary artery and its branches among pitchers and other athletes is not known, nor is it clear whether pitchers who are at high risk of vascular injury can be identified before irreversible damage to the vessels has occurred. Perhaps patients who have documented compression or occlusion of the vessel with the arm in the abducted, externally rotated position are at higher risk. Screening pitchers to identify those with axillary artery compression, aneurysm, or thrombosis has also not been shown to be effective. Certainly, many pitchers will have some level of compression of the axillary artery with their arm in the pitching position but will never develop any clinical abnormality requiring treatment. Screening would therefore probably lead to a high false-positive rate. It is clear, however, that pitchers who complain of ischemia-type symptoms such as early fatigue or who have evidence of emboli require a complete evaluation to rule out any abnormality of the axillary artery or one of its branches. Orthopaedic surgeons who see pitchers and other athletes involved in repetitive overhead motions need to be aware of this disorder so that they order the appropriate tests and obtain a vascular consultation--and make a prompt diagnosis. Treatment will vary depending on the type of lesion and on which vessel or vessels are involved, and should be decided on by the team of surgeons treating the patient.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/18. indocyanine green angiographic features of choroidal rupture and choroidal vascular injury after contusion ocular injury.PURPOSE: To report features of choroidal rupture and choroidal vascular injury after contusion ocular injury on indocyanine green angiography. methods: In a prospective study, nine patients (nine eyes) with choroidal rupture after ocular contusion underwent initial fluorescein angiography and indocyanine green angiography within 19 days after trauma. Eyes that had a distinct abnormality of the retinal pigment epithelium were excluded from this study. Subtraction indocyanine green angiography was also performed. Follow-up fluorescein angiographic and indocyanine green angiographic findings were also studied. RESULTS: Initial ophthalmoscopic examination revealed subretinal hemorrhage in all nine eyes. In five of the nine eyes, choroidal rupture was not seen on initial ophthalmoscopic or fluorescein angiographic examination because it was hidden beneath the subretinal hemorrhage, but it was detected on subsequent examinations. In the remaining four eyes, choroidal rupture was observed by ophthalmoscopy at the time of initial examination, and these eyes exhibited hyperfluorescent streaks on fluorescein angiography in the region of the subretinal hemorrhage. On initial indocyanine green angiography of all nine eyes, observed hypofluorescent streaks became more obvious with time. For each eye, there were more hypofluorescent streaks on indocyanine green angiography than hyperfluorescent streaks on fluorescein angiography. In one eye, the location of indocyanine green leakage nearly coincided with the location of a hyperfluorescent streak on fluorescein angiography. In this case, crescentic streaks of hypofluorescence were seen on the temporal side of the subretinal hemorrhage on indocyanine green angiography, although choroidal rupture was not observed in that region by ophthalmoscopy or fluorescein angiography. In two of the nine eyes, indocyanine green angiography and the subtraction technique demonstrated disturbance of flow into choroidal vessels, especially at the choroidal rupture site. CONCLUSION: After ocular contusion injury, various features of choroidal rupture and choroidal vascular injury were observed on indocyanine green angiography. This technique may contribute to the diagnosis of choroidal rupture and to the understanding of the clinical course after injury.- - - - - - - - - - ranking = 0.11111111111111keywords = vessel (Clic here for more details about this article) |
3/18. survival of an aortic trauma patient with ehlers-danlos syndrome type IV: a case report.ehlers-danlos syndrome type IV is the most lethal variant of that illness and is associated with fatal large vessel arterial hemorrhages. The literature reports only two survivors of elective aortic surgery and two survivors of spontaneous aortic hemorrhage. This article presents a 14-year-old boy who had aortic and vena cava blunt trauma and survived.- - - - - - - - - - ranking = 0.11111111111111keywords = vessel (Clic here for more details about this article) |
4/18. Laparoscopic distal pancreatectomy for blunt injury to the pancreas. A case report.Laparoscopic pancreatic resection has not been reported for traumatic injuries to the pancreas. We present the case of a laparoscopic distal pancreatectomy performed on a 10-year-old boy after he sustained a distal transection of the pancreas due to blunt abdominal trauma. The spleen and its vessels were preserved. The patient was sent home on postoperative day 3 without any postoperative complications. Performing an advanced laparoscopic pancreatic procedure is feasible, in the trauma setting, particularly in children.- - - - - - - - - - ranking = 0.11111111111111keywords = vessel (Clic here for more details about this article) |
5/18. Traumatic superficial temporal artery pseudoaneurysms in a minor league baseball player: a case report and review of the literature.Traumatic STA aneurysm is a rare complication of facial trauma occuring typically in young men. We present the case of a minor league baseball player who developed 2 pseudoaneurysms after being struck by a baseball and review all cases associated with sports activities. Reports associated with sports activities are increasing and may represent an increasing incidence. The team physician should suspect this condition when a player presents with a new temporal mass after facial trauma. diagnosis is typically made on history and physical examination, but can be confirmed by duplex ultrasound. Definitive treatment is surgical resection of the aneurysm after proximal and distal ligation of the vessel.- - - - - - - - - - ranking = 0.11111111111111keywords = vessel (Clic here for more details about this article) |
6/18. Apophysitis of the ischial tuberosity mimicking a neoplasm on magnetic resonance imaging.We present multimodality imaging features of an ischial tuberosity apophysitis in a 13-year-old boy who was an active baseball pitcher. Roentgenography of the pelvis and computed tomography showed mild irregularity in the inferior margin of the left ischial tuberosity. T1-weighted MRI showed a wide area with low signal intensity in the left ischial body; T2-weighted fat-suppression images showed areas with markedly high signal intensity in the ischial apophysis and body and the surrounding periosteum; contrast-enhanced T1-weighted fat-suppression MRI showed that the ischial body, surrounding periosteum, and origin of the hamstring muscles strongly enhanced; technetium-99m scintigraphic scans showed increased isotope uptake in the entire ischial body. Histological specimens obtained from the bone showed increased osteoblastic activity, edema, and proliferation of benign spindle cells and small vessels in the bone marrow spaces. In the present case, because MR imaging demonstrated extensive signal abnormalities involving the apophysis, periosteum, and intramedullary portion of bone, a neoplasm could not be excluded, and a biopsy was undertaken.- - - - - - - - - - ranking = 0.11111111111111keywords = vessel (Clic here for more details about this article) |
7/18. Traumatic pseudoaneurysm in a wrestler.An 18-year-old man sought treatment for a pulsatile mass in the medial distal thigh four years after he had sustained blunt trauma during a wrestling match. Investigation, which included magnetic resonance imaging and arteriography, showed the mass to be a pseudoaneurysm, which should be considered in the differential diagnosis of masses resulting from direct, blunt trauma. At exploration, a pseudoaneurysmic thrombus in the superficial femoral artery was evacuated and the vessel was repaired with an interposition graft of reversed saphenous vein, followed by complete recovery of the patient.- - - - - - - - - - ranking = 0.11111111111111keywords = vessel (Clic here for more details about this article) |
8/18. "Effort" thrombosis of the axillary and subclavian vein associated with cervical rib and oral contraceptives in a young woman athlete."Effort" thrombosis, also called the Paget-Schroetter syndrome or primary thrombosis of the upper extremity, has been well documented in the literature. However, in our review of the united states, Canadian, and British literature, we found only 52 cases in which it was related to sports participation. We report a case of axillary and subclavian vein "effort" thrombosis in a young woman athlete, who was predisposed to thrombosis by all three postulates of the Virchow triad: namely, (1) stasis caused by constriction from a cervical rib, (2) increased coagulability as a result of oral contraceptive use, and (3) vessel wall injury because of competitive softball participation. Of the available therapeutic plans, we believe that athletes with "effort" thrombosis should have aggressive treatment that is initiated as early as possible to prevent swelling, tingling numbness, easy fatigue of the arm, and pain on prolonged use of the affected extremity.- - - - - - - - - - ranking = 0.11111111111111keywords = vessel (Clic here for more details about this article) |
9/18. The medial head of the gastrocnemius. A review of the basis for partial rupture and for intermittent claudication.Under physical stress, partial or complete tears of the muscle fibers of the medial head of the gastrocnemius may occur. Radiographs made by soft-tissue technique can be especially helpful in diagnosing partial ruptures, which are sometimes difficult to detect. intermittent claudication can be caused by an abnormal position of the medial head of the gastrocnemius, resulting in compression of the popliteal vessels. Angiography or computerized tomography will usually disclose the site of local pressure. Surgical intervention may be necessary to eliminate the compression.- - - - - - - - - - ranking = 0.11111111111111keywords = vessel (Clic here for more details about this article) |
10/18. Trauma, sport, and malignant cerebral edema.Sudden cerebral swelling and death secondary to craniocerebral trauma has been noted in children and young adults. This is due to an increase in intracerebral blood, either secondary to an increase in cerebral blood volume or a redistribution of intracranial blood from the pial to the intraparenchymal vessels. Sequential craniocerebral trauma has been associated with the syndrome of "malignant cerebral edema"; the possibility of a "compliance compromised brain" has been suggested as the cause. The additional possibility of asymptomatic encephalitis leading to a compliance compromised brain and malignant cerebral edema is discussed.- - - - - - - - - - ranking = 0.11111111111111keywords = vessel (Clic here for more details about this article) |
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