scholarly journals Traumatic laceration of the portal vein

CJEM ◽  
2015 ◽  
Vol 18 (4) ◽  
pp. 306-308 ◽  
Author(s):  
Ahmet Kama ◽  
Savas Coskun ◽  
Melih Yuksel ◽  
Ali Cihat Yildirim ◽  
Elnare Gunal ◽  
...  
Keyword(s):  
Portal Vein ◽  
Hemodynamic Instability ◽  
Minor Trauma ◽  
Unique Case ◽  
Portal Triad ◽  
Traumatic Injuries ◽  
Vehicle Accident ◽  
Liver Injuries ◽  
Vein Injury

AbstractDespite its relatively protected position, the liver is the most frequently injured solid intra-abdominal organ.1 Most liver injuries can be managed conservatively, but about 5% to 10% require urgent laparotomy, usually when the mechanism of injury involves a vehicle accident and hemodynamic instability persists, in spite of 40 mL/kg of blood transfusion.2,3 In particular, grades IV and V liver injuries may pose a challenge to the surgeon trying to control hemorrhage, the leading cause of mortality.4 Traumatic injuries to the portal vein are rare but devastating. The mortality rate for portal vein injury ranges from 50% to 70%. A recent study of portal triad injuries has highighted the higher mortality rates associated with combination injuries involving multiple portal triad components, especially those that include portal vein injury.5 This case study describes a unique case of relatively minor trauma in a child resulting in portal triad injury, sudden demise, and surgical repair.

Gossypiboma: Is it always what it appears to be? A Rare Complication in Everyday Practice

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Daniel Sheffer
Keyword(s):  
Liver Injury ◽  
Rare Complication ◽  
Relevant Literature ◽  
Hemodynamic Instability ◽  
Hemostatic Agents ◽  
Radiologic Findings ◽  
Time Period ◽  
Liver Injuries ◽  
Intraabdominal Sepsis

Background: While the management of liver injury is usually conservative, the major indication for surgery remains hemodynamic instability. Different techniques are described for hemostasis in cases which require surgery. Several commercial hemostatic agents are readily available and can be used as an adjunct after the repair of the liver injuries. One of the most well-known local agents is gelfoam, which is used in multiple fields of surgery. The aim of this work is to present a very rare complication while using gelfoam, mimicking gossipiboma. Design: A case study describing a hemodynamically unstable patient who suffered from a penetrating liver injury. Hemostasis was achieved by liver suture and Gelfoam with subsequent angioembolization. In the post-operative period, the patient demonstrated signs of intraabdominal sepsis due to liver abscess. Repeated attempts of percutaneous drainage failed, and all cultures were negative. Due to a strong suspicion of a forgotten abdominal pad (gossipiboma), the patient was operated on and the object was removed. The final pathological report showed no textile in the specimen, the findings were compatible with a piece of gelfoam without any signs of absorption. Discussion and Conclusions: Commonly used hemostatic agents are made of gelatin gelfoams, microfibrillar collagen, thrombin, and fibrin sealant. Gelfoam is available in sponge or powder form. The sponge can be left in place and is supposed to be completely absorbed in four to six weeks. We found in the relevant literature only one case of gelfoam use related to granuloma formation. In our case, the radiologic findings in the liver were interpreted as an abscess. The suspicion of a foreign body was raised only during his second admission and thus forced us to operate. There is no clear reason why the piece of gelfoam wasn’t absorbed in that time period. Our assumption is that post angiography liver ischemia may have disturbed the process of fibrin destruction. The possibility of such condition should be considered when liver angioembolization is performed adjunct to surgical hemostasis using gelfoam.

Traumatic Injuries to the Portal Vein: Case Study

2004 ◽  
Vol 56 (4) ◽  
pp. 779-782 ◽  
Author(s):  
Jonathan Pearl ◽  
Alexander Chao ◽  
Susan Kennedy ◽  
Bikram Paul ◽  
Peter Rhee
Keyword(s):  
Portal Vein ◽  
Traumatic Injuries

scholarly journals Application of Levine’s Model in Nursing Care of Patient with Diabetic Foot: A Case Study

2020 ◽  
Vol 4 (1) ◽  
pp. 6
Author(s):  
Ida Ayu Agung Laksmi ◽  
Heri Kristianto ◽  
Tony Suharsono
Keyword(s):  
Nursing Care ◽  
Diabetic Foot ◽  
Single Case ◽  
Hemodynamic Instability ◽  
Design Data ◽  
Tissue Integrity ◽  
Damage Tissue ◽  
Conservation Problem ◽  
Conservation Model

Diabetic foot is such a life threatening condition for people with Diabetes Mellitus which it can be result in hemodynamic instability and loss of consciousness. In order to improve quality of nursing care in patient with diabetic foot, nurses should apply a nursing model approach. Levine conservation theoretical model is one of comprehensive model theory that can be applied in patients with critical diabetic foot in Emergency Department (ED). This case study describes a nursing care using Levine's Conservation Model to care for a patient with diabetic foot.  This study was a case study with a single case design. Data were collected using physical assessment, written communications with the patient, interviews patient family members, and observing the patient during intensive care in the ED of Lawang General Hospital on December 21th, 2015. Levine's Conservation Model used as the nursing guideline successfully identified patient issues including ineffective breathing pattern as a major priority of energy conservation problem and damage tissue integrity as a problem of structural conservation. Both of conservation problem were caused by patient's personal integrity conservation maladaptive that caused by ineffective therapeutic regimen management. Levine’s conservation model is useful to investigate nursing problem and applicable to solve the emergency condition of damage tissue integrity in patients with diabetic foot. Index Terms— diabetic foot, nursing care, levine’s conservation model.

Frontal Lobe Epilepsy Presenting as a Psychotic Disorder With Delusions and Hallucinations: A Case Study

CNS Spectrums ◽  
1999 ◽  
Vol 4 (9) ◽  
pp. 64-66,82 ◽  
Author(s):  
Bonnie J. Ramsey
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Frontal Lobe ◽  
Psychotic Disorder ◽  
Temporal Lobe ◽  
Psychotic Disorders ◽  
Psychotic Symptoms ◽  
Frontal Lobe Epilepsy ◽  
Unique Case ◽  
Frontal Lobe Seizures

AbstractAlthough psychotic symptoms are a recognized manifestation of epilepsy, these are more often associated with seizures of the temporal lobe type. While 10% of children with temporal lobe epilepsy develop a psychotic disorder by adulthood, the literature does not report any cases of psychotic disorders associated with frontal lobe seizures in children. This article presents a unique case of a girl whose frontal lobe seizures were associated with delusional psychotic symptoms. Once her seizure disorder was identified through electroencephalography (EEG) and appropriate anticonvulsant therapy was initiated, her associated psychotic symptoms resolved.

Irrigation in the Medieval Islamic Fayyum: Local Control in a Large-Scale Hydraulic System

2012 ◽  
Vol 55 (1) ◽  
pp. 1-31 ◽  
Author(s):  
Yossef Rapoport ◽  
Ido Shahar
Keyword(s):  
Water Supply ◽  
Local Control ◽  
Water Allocation ◽  
Hydraulic System ◽  
Large Scale ◽  
Close Reading ◽  
Unique Case ◽  
Islamic Period ◽  
Distinctive Aspect

Abstract Because of the unique set of sources available, the Fayyum in Middle Egypt offers a unique case study of large-scale irrigation from antiquity to the Islamic period. A close reading of a cadastral survey of the province from 641/1243-4 shows that the distinctive aspect of the Islamic period was the local control of water supply and management. Drawing on the engineering experience of the villagers, water allocation and management in the gravity-fed canals of the Fayyum were in the hands of iqṭāʿ holders and tribal groups along the main canals, a pattern similar to that which pertained in mediaeval al-Andalus.

scholarly journals Stimulus-response time to invasive blood pressure alarms: implications for the safety of critical-care patients

2014 ◽  
Vol 35 (2) ◽  
pp. 135-141 ◽  
Author(s):  
Adele Kuckartz Pergher ◽  
Roberto Carlos Lyra da Silva
Keyword(s):  
Blood Pressure ◽  
Response Time ◽  
Response Times ◽  
Hemodynamic Instability ◽  
Military Hospital ◽  
Invasive Blood Pressure ◽  
Stimulus Response ◽  
The City ◽  
Physical Layout

Observational, descriptive, exploratory, case study with the objective of measuring the stimulus-response time of the team to alarms monitoring invasive blood pressure (IBP) and analyzing the implications of this time for the safety of the patient. From January to March 2013, 60 hours of structured observation were conducted with registration of the alarms activated by IBP monitors in an adult ICU at a military hospital in the city of Rio de Janeiro. 76 IBP alarms were recorded (1.26 alarms/hour), 21 of which (28%) were attended to and 55 (72%) considered as fatigued. The average response time to the alarms was 2 min. 45 sec. The deficit in human resource and physical layout were factors determining the delay in response to the alarms. The increase in response times to these alarms may compromise the safety of patients with hemodynamic instability, especially in situations such as shock and the use of vasoactive drugs.

Procedural Justice in International Criminal Courts: Assessing Civil Parties’ Perceptions of Justice at the Extraordinary Chambers in the Courts of Cambodia

2016 ◽  
Vol 16 (1) ◽  
pp. 1-38 ◽  
Author(s):  
Rachel Killean
Keyword(s):  
Procedural Justice ◽  
Transitional Justice ◽  
International Criminal ◽  
International Criminal Law ◽  
Criminal Courts ◽  
Unique Case ◽  
Mass Violence ◽  
Participant Satisfaction ◽  
Decision Making Processes

Procedural justice advocates argue that fair procedures in decision making processes can increase participant satisfaction with legal institutions. Little critical work has been done however to explore the power of such claims in the context of mass violence and international criminal justice. This article critically examines some of the key claims of procedural justice by exploring the perceptions of justice held by victims participating as Civil Parties in the Extraordinary Chambers in the Courts of Cambodia (eccc). The eccc has created one of the most inclusive and extensive victim participation regimes within international criminal law. It therefore provides a unique case study to examine some of claims of ‘victim-centred’ transitional justice through a procedural justice lens. It finds that while procedural justice influenced civil parties’ overall perceptions of the Court, outcomes remained of primary importance. It concludes by analysing the possible reasons for this prioritisation.

scholarly journals Confidence Frames and the Mastery of New Challenges in the Motivation of an Expert Skydiver

2014 ◽  
Vol 28 (3) ◽  
pp. 221-232 ◽  
Author(s):  
John H. Kerr ◽  
Susan Houge Mackenzie
Keyword(s):  
Goal Achievement ◽  
Reversal Theory ◽  
Personal Goal ◽  
Unique Case ◽  
Research Findings ◽  
New Challenges ◽  
General Experience ◽  
Theory Research ◽  
Dangerous Activity

The main objective was to further unravel the experience of motivation in an expert male skydiver by investigating: (1) his general experience of motivation and perception of the dangers of skydiving; (2) his pursuit of new challenges and learning new skills as factors in maintaining motivation; (3) evidence of a mastery-based confidence frame in his motivational experience. This was a unique case study informed by reversal theory. The participant’s perception of skydiving was that it was not a risky or dangerous activity and a primary motive for his involvement in skydiving was personal goal achievement. Maintaining control and mastery during skydiving was a key motivational element during his long career and pursuing new challenges and learning new skills was found to be important for his continued participation. Data indicated that his confidence frame was based on a telic-mastery state combination, which challenged previous reversal theory research findings and constructs.

Teacher-Designed Games

2021 ◽  
pp. 123-147
Author(s):  
Yang Liu
Keyword(s):  
Video Games ◽  
School Districts ◽  
Student Learning ◽  
Mixed Method ◽  
Game Based Learning ◽  
Unique Case ◽  
Data Coding ◽  
Digital Classroom

Video games play an important role in education; however, the idea of teachers as designers of digital classroom games to support student learning has not been widely embraced. The purpose of this study was to gain a deeper understanding of why and how teachers used and designed games in teaching differently with various gaming background. This mixed-method case study involved a group of teachers who used and/or designed games for students. The four unique case groups were grounded in three regions and four school districts in Alberta, Canada. First and second cycle data coding and analyses were used to answer 1) what factors influenced the types of games teachers used and designed in teaching and 2) what factors influenced how and why teachers integrated game-based learning in teaching.

Sign in / Sign up

Export Citation Format

Share Document