scholarly journals Post-trauma transmesocolic hernia: a case report

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Doaa Hussin Salam ◽  
Mohannad Al-Tarakji ◽  
Abubaker Ibrahim Alaieb ◽  
Rajvir Singh ◽  
Ayman El-Menyar ◽  
...  
Keyword(s):  
Bowel Obstruction ◽  
Motor Vehicle ◽  
Epigastric Pain ◽  
Abdominal Distension ◽  
Emergency Laparotomy ◽  
Trauma Patients ◽  
Male Victim ◽  
Internal Hernias ◽  
Vehicle Collision ◽  
Clinical Consequences

Abstract The prevalence of transmesocolic hernias, a subtype of internal hernias (IHs), is generally low. Its clinical consequences, including strangulation, ischemia and even death, however, necessitate awareness. IHs are classified as congenital or acquired as resulting from surgery, trauma or intraperitoneal inflammation. This is a case of a 37-year-old male victim of a motor vehicle collision 1 month prior to the index admission. The trauma-related injuries were managed conservatively and then discharged home. The patient was re-admitted with a 2-day history of epigastric pain, vomiting and abdominal distension. A diagnosis of small bowel obstruction due to a transmesocolic hernia was made on CT and emergency laparotomy performed. The post-operative course was unremarkable. It is vital to consider transmesocolic hernias in trauma patients presenting with a picture of bowel obstruction even in the absence of prior surgery.

scholarly journals Traumatic Brain Injury Caused by Motor Vehicle Collision and Alcoholism in Piauí

2016 ◽  
Vol 37 (03) ◽  
pp. 174-181
Author(s):  
Benjamim Vale ◽  
Juçara Castro ◽  
Marx Araújo ◽  
Herb Morais ◽  
Lívio Macêdo
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Motor Vehicle ◽  
Care Service ◽  
Diffuse Axonal Injury ◽  
Total Sample ◽  
Motor Vehicle Collision ◽  
Alcoholic Beverages ◽  
Trauma Patients ◽  
Vehicle Collision

Objectives To determine the relationship between alcohol consumption and the incidence of traumatic brain injury (TBI) with diffuse axonal injury (DAI), determining these indices, checking acquired comorbidities and characterizing the patients by gender, age and race/color, as well as describing the characteristics of the motor vehicle collision (vehicle, period of the day, day of the week and site) in people admitted to an emergency hospital in the city of Teresina, in the state of Piauí, Brazil. Methods We have analyzed the data contained in the medical records of patients admitted with a history of motor vehicle collision and severe TBI in intensive care units, based on the forms provided by the Mobile Emergency Care Service (SAMU, in the Portuguese acronym) in the period between February 28 and November 28, 2013. Results In the period covered by the present study, 200 individuals were analyzed, and 54 (27%) had consumed alcohol; of these 11 had DAI. Of the total sample, 17% (34) presented DAI, however, with unknown data regarding the consumption of alcoholic beverages. Conclusion Considering the data, we observed that the profile of the head trauma patients are brown men, mostly (53.5%) aged between 15 and 30 years. The collisions occurred mostly on weekends and at night (55%), and 89.5% of the crashes involved motorcycles.

scholarly journals A rare case of COVID-19 related stomach gangrene after an abortion: a case report

2021 ◽  
Vol 8 (4) ◽  
pp. 1360
Author(s):  
Komal Gupta ◽  
Gopal Puri ◽  
Jnaneshwari Jayaram ◽  
Muhammed Huzaifa ◽  
Kamal Kataria
Keyword(s):  
Epigastric Pain ◽  
Subtotal Gastrectomy ◽  
Abdominal Distension ◽  
Posterior Wall ◽  
Emergency Laparotomy ◽  
Rt Pcr ◽  
Missed Abortion ◽  
Medical Termination ◽  
Arterial Thrombus ◽  
Severe Epigastric Pain

A 25 year old female had presented with complaints of severe epigastric pain with abdominal distension and vomiting for 4 days. She had undergone medical termination of pregnancy for a missed abortion of 5 weeks of gestation 5 days prior. The patient's COVID-19 RT PCR was found to be positive. Her CECT showed covid related changes in bilateral lungs and pneumoperitoneum. Stomach was distended. Other small bowels appeared normal. Patient underwent emergency laparotomy. Two third of stomach appeared gangrenous with a perforation in the posterior wall of stomach so she underwent a subtotal gastrectomy. She had features of covid associated coagulopathy (CAC) with high D-dimer (520 ng/ml), thrombocytosis (up to 705,000/mcl), high activated partial thromboplastin time (aPTT) (up to 55.6 sec) and high prothrombin time (PT) (up to 27.9 sec and INR 2.11) for which low molecular heparin was given. Stomach is a highly vascular organ. Gangrene of the stomach has been very rarely reported. CAC is known to lead to both arterial thrombus and venous thromboembolism. COVID-19 related abortions have also been reported though the exact mechanism not certain but CAC could be one of them.

scholarly journals Small bowel obstruction due to splenosis 30 years after splenectomy

2020 ◽  
Vol 102 (9) ◽  
pp. e1-e3
Author(s):  
E El-Helou ◽  
M Alimoradi ◽  
H Sabra ◽  
Y Ghoussoub ◽  
Mariana Zaarour ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Motor Vehicle ◽  
Splenic Rupture ◽  
Mass Effect ◽  
Splenic Tissue ◽  
Splenic Trauma ◽  
Vehicle Collision ◽  
Multiple Nodules

Splenosis is the autotransplantation of splenic tissue into abnormal locations due to trauma or iatrogenically. Usually, this causes no symptoms, but in rare cases the mass effect of the transplanted nodules can cause small bowel obstruction. Resection of the culprit splenic tissue is recommended, but not more extensive dissection of non-involved nodules. Our patient presented at 43 years of age with abdominal pain, distention and bilious vomiting. He had undergone a splenectomy at the age of 13 years due to splenic rupture after a motor vehicle collision. Computed tomography demonstrated a small bowel obstruction with multiple nodules suspicious of splenosis. The obstructing mass and compromised bowels. were resected. Final pathology confirmed the diagnosis. Splenosis is an uncommon aetiology of small bowel obstruction and must be considered in patients who had previous splenic trauma or surgery.

Rhabdomyolysis in Obese Trauma Patients

2014 ◽  
Vol 80 (10) ◽  
pp. 1012-1017
Author(s):  
Joshua L. Chan ◽  
Taryne Imai ◽  
Galinos Barmparas ◽  
Jonathan B. Lee ◽  
Alex W. Lamb ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Obese Group ◽  
Surgical Intensive Care Unit ◽  
Trauma Patients ◽  
Surgical Intensive Care ◽  
Traumatic Injuries ◽  
Vehicle Collision ◽  
Level I ◽  
Level Monitoring

Patients sustaining traumatic injuries are at risk for development of rhabdomyolysis. The effect of obesity on this risk is unknown. This study attempted to characterize the role of obesity in the development of rhabdomyolysis after trauma. This was a retrospective review of all trauma patients with creatine kinase (CK) levels admitted to the surgical intensive care unit (SICU) at a Level I trauma center from February 2011 until July 2013. Patients were divided based on their body mass index (BMI): overweight/obese group with BMI 25 kg/m2 or greater and nonoverweight/obese group with BMI less than 25 kg/m2. Primary outcome was CK greater than 10,000 U/L. During the 30-month study period, 198 trauma patients with available CK levels were admitted to the SICU. The majority (27.8%) of patients were involved in a motor vehicle collision. There were 96 patients (48.4%) with BMI 25 kg/m2 or greater and 102 (51.5%) with BMI less than 25 kg/m2. There was no difference in creatinine levels between the two groups (1.5 ± 1.2 mg/dL vs 1.5 ± 1.4 mg/dL, P = 0.83). BMI 25 kg/m2 or greater was independently associated with the development of CK greater than 10,000 U/L (14.6 vs 4.9%; adjusted odds ratio, 3.03; P = 0.04). Patients with BMI 25 kg/m2 or greater are at a significantly higher risk for rhabdomyolysis after trauma. Aggressive CK level monitoring to prevent rhabdomyolysis in this population is strongly encouraged.

scholarly journals Transmesocolon internal hernia masking as simple sigmoid volvulus

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Han N Beh ◽  
Yuni F Ongso ◽  
David B Koong
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Large Bowel ◽  
Sigmoid Volvulus ◽  
Emergency Laparotomy ◽  
Transverse Mesocolon ◽  
Hartmann Procedure ◽  
Internal Hernias ◽  
Colonic Decompression

Abstract Transmesocolon internal hernias are very rare causes of bowel obstruction. Transmesenteric internal hernias normally associated with small bowel. It can be challenging to diagnose transmesocolon internal hernia hence we present a 93-year-old patient who was misdiagnosed with simple sigmoid volvulus on CT abdomen. She underwent endoscopic colonic decompression. Patient continued to deteriorate in the ward, and CT abdomen was repeated; it revealed the cause of the sigmoid volvulus was due to a defect through transverse mesocolon resulting in internal hernia. Patient was diagnosed with transmesocolic internal hernia with sigmoid volvulus. Patient underwent emergency laparotomy and Hartmann procedure. Transmesocolic internal hernia can be easily missed and needs to be considered when diagnosing patients with large bowel volvulus or obstruction.

scholarly journals Case Report: Delayed Presentation of Bowel Obstruction Caused by Blunt Abdominal Trauma

2020 ◽  
Vol 4 (4) ◽  
pp. 620-622
Author(s):  
Nicholas George ◽  
Charles Baldi ◽  
James Tonascia ◽  
Siamak Moayedi
Keyword(s):  
Case Report ◽  
Bowel Obstruction ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
High Speed ◽  
Bowel Wall ◽  
Motor Vehicle ◽  
Delayed Presentation ◽  
Vehicle Collision ◽  
Post Traumatic

Introduction: Bowel obstruction is a rare but well reported complication of blunt abdominal trauma (BAT). Obstruction is most often seen acutely caused by bowel wall hematomas and chronically as a result of post-traumatic strictures. Here, we present a novel case of BAT causing a subacute obstructing bowel wall hematoma. Case Report: A healthy, 32-year-old male presented to our emergency department with three days of nausea and vomiting. Chart review revealed he had been seen two weeks prior after a high-speed motor vehicle collision. During that initial visit, the patient had a benign abdominal exam and was discharged without imaging. On this return visit, the patient was found to have a large, obstructing colonic hematoma. Conclusion: Because emergency physicians care for patients in both the acute and subacute phases of trauma, clinicians should recognize the more subtle sequelae of BAT.

scholarly journals Utility of an orthopaedic trauma registry in Ghana

2021 ◽  
Vol 55 (3) ◽  
pp. 213-220
Author(s):  
Elissa K. Butler ◽  
Dominic Konadu-Yeboah ◽  
Peter Konadu ◽  
Dominic Awariyah ◽  
Charles N. Mock
Keyword(s):  
Quality Improvement ◽  
Data Quality ◽  
Trauma Registry ◽  
Motor Vehicle ◽  
Categorical Variables ◽  
Trauma Patients ◽  
Orthopaedic Trauma ◽  
Middle Income ◽  
Trauma Registries ◽  
Vehicle Collision

In most low- and middle-income countries, trauma registries are uncommon. Although institutional registries for all trauma patients are ideal, it can be more practical to institute departmental registries for specific subsets of patients. Komfo Anokye Teaching Hospital (KATH) has started a locally developed, self-funded orthopaedic trauma registry. We describe methods and experiences for data collection and examine patient and injury characteristics, data quality, and the utility of the registry. Of 961 individuals in the registry, 67.9% were males, and the median age was 40 years. Motor vehicle collision (23.3%) was the most frequent mechanism of injury. Lower extremity fractures were the most common injury (60.6%), and 43.9% of injuries were managed operatively. Data quality was reasonable with missingness under 10% for 13 of 14 key variables, with inconsistencies of dates of injury, admission, treatment, and discharge in 9.1% of cases. However, the type of operation was missing for 73.2% of operative cases. Despite these limitations, the registry has been used for quality improvement and to successfully advocate for resources to improve trauma care. The registry has been improved by adding more detailed outcome variables, creating a standardisedcodebook of categorical variables, and adding more fields to allow for multiple injuries. In conclusion, it is practical and sustainable to institute a locally developed, self-funded orthopaedic trauma registry in Ghana that provides data with reasonable quality. Such a registry can be used to advocate for more resources to care for injured patients adequately and for quality improvement.

scholarly journals Octogenarian Motor Vehicle Collisions: Injury Patterns Matter

2022 ◽  
Vol 15 (1) ◽  
pp. 336-340
Author(s):  
Michael Lemon ◽  
Stephen Helmer ◽  
Kathryn Soba ◽  
Jeanette Ward ◽  
James M Haan
Keyword(s):  
Injury Severity ◽  
Motor Vehicle ◽  
Oldest Old ◽  
Rural Setting ◽  
Common Mechanism ◽  
Trauma Patients ◽  
Injury Patterns ◽  
Discharge Disposition ◽  
Vehicle Collision ◽  
Potential Factors

Introduction.  Motor vehicle collision (MVC) is the second most common mechanism of injury among octogenarians and is on the rise.  These “oldest old” trauma patients have much higher mortality rates than expected.  This study examined potential factors influencing this increased mortality including comorbidities, medications, injury patterns, and hospital interventions. Methods.  A 10-year retrospective review was conducted of patients aged 80 and over who were injured in a MVC.  Data collected included patient demographics, comorbidities, medication use prior to injury, collision details, injury severity and patterns, hospitalization details, outcomes, and discharge disposition. Results.  We identified 239 octogenarian patients involved in a MVC.  Overall mortality was 18.8%.  We recognized an increased mortality for specific injury patterns, patients injured in a rural setting, and those who were transfused, intubated, or admitted to the ICU.  We found no correlation between mortality and medications or comorbidities. Conclusions.  The high mortality rate for octogenarian patients involved in a MVC is related to injury severity, type of injury, and in-hospital complications, and not due to comorbidities and prior medications.

scholarly journals Case Report: Right paraduodenal hernia – a unique case of rare internal hernia presenting as acute small bowel obstruction

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 1282
Author(s):  
Brikha Raj Joshi ◽  
Swotantra Gautam ◽  
Saroj Adhikari Yadav ◽  
Rakesh Kumar Gupta
Keyword(s):  
Case Report ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Internal Hernia ◽  
Prior History ◽  
Emergency Laparotomy ◽  
Paraduodenal Hernia ◽  
Internal Hernias ◽  
Right Paraduodenal Hernia

Paraduodenal hernia, a rare internal hernia, is an uncommon cause of small bowel obstruction. We present a case report of a 45-year-old male presenting to the emergency department with complaints suggestive of small bowel obstruction. Abdominal plain X-ray was also suggestive of small bowel obstruction. Emergency laparotomy showed intraoperative findings of right sided paraduodenal hernia with dilated small bowel. Postoperative hospital stay was uneventful and the patient was doing well during 24 months of follow up with no active complaints. Paraduodenal hernia should be considered as part of the differential diagnosis of small bowel obstruction in patients who have repeated attacks and no prior history of abdominal surgery. Surgeons need to have an astute clinical acumen in diagnosing internal hernias to avoid repercussions and fatal events.

Epidemiology of Post-Traumatic Limb Amputation: A National Trauma Databank Analysis

2010 ◽  
Vol 76 (11) ◽  
pp. 1214-1222 ◽  
Author(s):  
Galinos Barmparas ◽  
Kenji Inaba ◽  
Pedro G.R. Teixeira ◽  
Joseph J. Dubose ◽  
Michele Criscuoli ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Skilled Nursing Facility ◽  
Limb Amputation ◽  
Trauma Patients ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Vehicle Collisions ◽  
National Trauma ◽  
Vehicle Collision ◽  
Post Traumatic

The purpose of this study was to examine the epidemiology and outcomes of posttraumatic upper (UEA) and lower extremity amputations (LEA). The National Trauma Databank version 5 was used to identify all posttraumatic amputations. From 2000 to 2004 there were 8910 amputated patients (1.0% of all trauma patients). Of these, 6855 (76.9%) had digit and 2055 (23.1%) had limb amputation. Of those with limb amputation, 92.7 per cent (1904/2055) had a single limb amputation. LEA were more frequent than UEA among patients in the single limb amputation group (58.9% vs 41.1%). The mechanism of injury was blunt in 83 per cent; most commonly after motor vehicle collisions (51.0%), followed by machinery accidents (19.4%). Motor vehicle collision occupants had more UEA (54.5% vs 45.5%, P < 0.001), whereas motorcyclists (86.2% vs 13.8%, P < 0.001) and pedestrians (91.9% vs 8.1%, P < 0.001) had more LEA. Patients with LEA were more likely to require discharge to a skilled nursing facility; whereas those with UEA were more likely to be discharged home. Traumatic limb amputation is not uncommon after trauma in the civilian population and is associated with significant morbidity. Although single limb amputation did not impact mortality, the need for multiple limb amputation was an independent risk factor for death.

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