scholarly journals Acute Pseudohepatitis in a Chronic Substance Abuser Secondary to Occult Seat Belt Injury

1999 ◽  
Vol 13 (2) ◽  
pp. 155-158 ◽  
Author(s):  
Eric CS Lam ◽  
Rhonda M Janzen ◽  
R Mark Meloche ◽  
Paul J Trepanier ◽  
Eric M Yoshida
Keyword(s):  
Liver Dysfunction ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Seat Belt ◽  
Traumatic Injury ◽  
Surgical Trauma ◽  
Vehicle Accidents ◽  
Serum Aminotransferases ◽  
The Right ◽  
High Index Of Suspicion

Causes of a massive elevation in serum aminotransferases (aspartate aminotransferase [AST] and alanine aminotransferase [ALT]) in the substance-abusing patient include viral hepatitis and drug hepatotoxicity. A patient chronically addicted to injection heroin and cocaine presented to the emergency room in a confused state and was admitted to a medical ward with an AST of 4120 U/L, ALT 3820 U/L and right upper quadrant discomfort. Investigations for viral and hepatotoxic causes for the liver dysfunction revealed only hepatitis C seropositivity. A computed tomogram of the abdomen, however, revealed a significant contusion to the right lobe of the liver consistent with traumatic injury. A motor vehicle accident, in which the patient was wearing a seat belt, and which had occurred a few days before admission and had been thought to be minor, was the cause of the liver dysfunction. Significant blunt abdominal traumatic injuries are usually managed exclusively by surgical trauma units. This case underlines the need for medical specialists to be aware of hepatic contusion injuries and to have a high index of suspicion when investigating unexplained hepatocellular dysfunction in chronic substance abusers who have been in motor vehicle accidents.

scholarly journals Traumatic Aortic Injury in a 3-Year-Old Child - A Case Report and Literature Review

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Aljohani M ◽  
◽  
Alanazi S ◽  
Keyword(s):  
Case Report ◽  
Significant Contribution ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Aortic Injury ◽  
Vehicle Accidents ◽  
Vehicle Accident ◽  
Pseudo Aneurysm ◽  
High Index Of Suspicion ◽  
Tomography Scan

This case report describes a case of aortic injury with pseudo-aneurysm in a 3-year-old Saudi boy following a motor vehicle accident. The diagnosis was suspected on computed tomography scan, and emergency surgery was performed. A Dacron graft was inserted to repair the injured aorta. Postoperatively, absent femoral, and distal pulses were noted, and thromboembolectomy was performed with good outcome. We believe that our study makes a significant contribution to the literature because it raises awareness of aortic injury and rupture in pediatric patients with multi-organ trauma following motor vehicle accidents. A high index of suspicion and early intervention are essential in improving outcomes.

Probability Analysis of Motor Vehicle Accidents

2002 ◽  
Author(s):  
Scott Kimbrough
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Probability Analysis ◽  
Maximum Information ◽  
Vehicle Accidents ◽  
Vehicle Accident ◽  
Stop Sign ◽  
Oncoming Vehicle ◽  
Probability Methods ◽  
The Right

Probability analysis is the key to extracting the maximum information from the evidence surrounding a motor vehicle accident. Moreover, it gives essential perspective to the answers drawn from the evidence, by conveying the uncertainty about the answers. In this paper, probability methods are used to analyze a typical intersection type collision between two vehicles. It is a situation in which one of the vehicles pulls out from a stop sign into the path of the other vehicle, which had the right of way. The vehicle that pulls out into the path of the oncoming vehicle precipitates the accident, but the driver of the oncoming vehicle may have contributed to the accident by traveling at excessive speed and or by being inattentive.

Meralgia paresthetica secondary to lipoma

2010 ◽  
Vol 12 (1) ◽  
pp. 103-105 ◽  
Author(s):  
Cheng-Shyuan Rau ◽  
Ching-Hua Hsieh ◽  
Yueh-Wei Liu ◽  
Lin-Yi Wang ◽  
Ming-Hsiung Cheng
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Seat Belt ◽  
Iliac Crest Bone Graft ◽  
Sartorius Muscle ◽  
Meralgia Paresthetica ◽  
First Case ◽  
Electrophysiological Studies ◽  
Bone Graft Harvesting ◽  
The Right

Meralgia paresthetica (MP) consists of pain or dysthesia in the lateral thigh caused by entrapment of the lateral femoral cutaneous nerve (LFCN) underneath the inguinal ligament. The causes include iliac crest bone graft harvesting, seat belt injury associated with motor vehicle accident, diabetes mellitus, and trauma. The authors present the case of a 50-year-old woman who had a 1-year history of right-sided MP. The patient's history and the results of physical and radiological examinations were otherwise unremarkable except for the finding of a lipoma over the surface of the right sartorius muscle. Electrophysiological studies were interpreted as demonstrating peripheral neuropathy only. Conservative treatment, including heat or ice packing and local anesthetic and steroid injections, failed to control the patient's symptoms. Although sectioning or neurolysis of the LFCN appears to offer good-to-excellent results, the patient underwent excision of the lipoma. The symptoms resolved completely. To the best of the authors' knowledge this is the first case of MP associated with compression caused by a lipoma. The authors conclude that lipoma compression can cause MP, and in such cases, total excision of the lipoma may resolve the condition.

Minimally Invasive Procedures for Diagnosis of Traumatic Right Diaphragmatic Tears: A Method for Correct Diagnosis in Selected Patients

2007 ◽  
Vol 73 (4) ◽  
pp. 388-392 ◽  
Author(s):  
Yoav Mintz ◽  
David W. Easter ◽  
Uzi Izhar ◽  
Yair Edden ◽  
Mark A. Talamini ◽  
...  
Keyword(s):  
Diagnostic Laparoscopy ◽  
Motor Vehicle ◽  
Correct Diagnosis ◽  
Traumatic Rupture ◽  
Respiratory Compromise ◽  
Vehicle Accidents ◽  
Left Diaphragm ◽  
Key Factor ◽  
The Right ◽  
High Index Of Suspicion

Traumatic rupture of the diaphragm is no longer uncommon. Because of the increasing frequency of motor vehicle accidents, the rate of blunt trauma to the chest and abdomen, which are the most common causes of diaphragmatic rupture, is increased as well. However, the diagnosis is frequently missed or delayed because of the lack of sensitivity and specificity of imaging modalities. Diagnostic laparoscopy is considered a standard tool for penetrating injuries to the left diaphragm and is widely practiced in selected cases. Right diaphragmatic tears, however, are more difficult to diagnose because of the sealing effect of the liver. Blunt abdominal trauma can cause large right diaphragmatic tears, causing liver incarcerations and respiratory compromise, therefore demanding the need for a comparable diagnostic tool. A high index of suspicion, together with knowledge of the mechanism of trauma, is the key factor for the correct diagnosis. Once the diagnosis has been considered, diagnostic laparoscopy and/or diagnostic thoracoscopy should be performed to confirm or rule out this injury. Factors suggestive of a right diaphragmatic tear include newly or progressive elevation of the right diaphragm and respiratory distress without underlining lung injury. The timing of the procedure should be in accordance with the hemodynamic and respiratory status of the patient. This procedure should be performed semielectively if there are no other indications for surgical intervention.

scholarly journals Effect of an educational leaflet on the frequency of seat belt use and the rate of motor vehicle accidents during pregnancy in Japan in 2018: a prospective, non-randomised control trial with a questionnaire survey

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031839 ◽  
Author(s):  
Mamoru Morikawa ◽  
Takashi Yamada ◽  
Hiromasa Kogo ◽  
Masaki Sugawara ◽  
Akira Nishikawa ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Seat Belt ◽  
Intervention Group ◽  
Motor Vehicle Accidents ◽  
Randomised Control Trial ◽  
Control Group ◽  
Vehicle Accidents ◽  
Vehicle Accident ◽  
Seat Belt Use

ObjectiveTo determine whether an educational leaflet had any effect on seat belt use, seat preference and motor vehicle accidents rate during pregnancy in Japan.DesignProspective, non-randomised control trial with a questionnaire survey.SettingEight obstetric hospitals in Sapporo, Japan.Participants2216 pregnant women, of whom 1105 received the leaflet (intervention group) and 1111 did not (control group).InterventionsDistribution of an educational leaflet on seat belt use to women in the intervention group.Primary outcome measuresThe effect of an educational leaflet on seat belt use, each pregnant woman’s seat preference and the women’s rates of motor vehicle accidents rate during their pregnancies. To evaluate the effects, the intervention group’s responses to the questionnaires were compared with those of the control group.ResultsThe proportion of subjects who always used seat belts during pregnancy was significantly higher in the intervention group (91.3%) than in the control group (86.7%; p=0.0005). Among all subjects, the percentage of women who preferred the driver’s seat was lower during pregnancy (27.0%) than before pregnancy (38.7%), and the percentage of women who preferred the rear seat was higher during pregnancy (28.8%) than before pregnancy (21.0%). These two rates did not differ between two groups. Seventy-one women (3.2%) reported experiencing a motor vehicle accident during pregnancy. The motor vehicle accident rate for the intervention group (3.3%) was similar to that for the control group (3.2%).ConclusionsAn educational seat belt leaflet was effective in raising the rate of consistent seat belt use during pregnancy, but it did not decrease the rate of motor vehicle accidents. The wearing of seat belts should be promoted more extensively among pregnant women to decrease rates of pregnancy-related morbidity and mortality from motor vehicle accidents.

Motor Vehicle Accident Trauma and Restraint Usage Patterns in Children Less Than 4 Years of Age

PEDIATRICS ◽  
1985 ◽  
Vol 76 (3) ◽  
pp. 382-386
Author(s):  
Phyllis F. Agran ◽  
Debora E. Dunkle ◽  
Diane G. Winn
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Seat Belt ◽  
Vehicle Interior ◽  
Use Patterns ◽  
Vehicle Accident ◽  
Restraint Use ◽  
Usage Patterns ◽  
Improper Use ◽  
Safety Seat

In a sample of children less than 4 years of age, treated in an emergency room after a motor vehicle accident, 22% were restrained in a child safety seat (improper and proper), 12% were restrained by a vehicle seat belt, and 70% were unrestrained. Trauma and injury patterns related to the various restraint use patterns are described. Most children in safety seats and seat-belted children, if injured, sustained minor contusions, abrasions, or lacerations. Injury among properly restrained children in safety seats was primarily the result of unavoidable mechanisms (eg, flying glass, intrusion). Improper use contributed to injury among safety-seat-restrained children, primarily by allowing the child to hit against the vehicle interior. Seat-belted children also were injured, primarily by hitting against the vehicle interior. Although some of the restrained children were seriously injured, in general, restrained children tended to sustain less serious and fewer injuries than the unrestrained children.

scholarly journals Early Identification of Traumatic Durotomy Associated with Atlantooccipital Dislocation May Prevent Retropharyngeal Pseudomeningocele Development

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Robert S. Qiu ◽  
Mina G. Safain ◽  
Max Shutran ◽  
Alejandra M. Hernandez ◽  
Steven W. Hwang ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Csf Leak ◽  
Rare Presentation ◽  
Vehicle Accident ◽  
C2 Nerve Root ◽  
Csf Diversion ◽  
The Right ◽  
Atlantooccipital Dislocation ◽  
Mri Image

Atlantooccipital dislocation can be complicated by a traumatic durotomy that may lead to the rare development of a retropharyngeal pseudomeningocele. To our knowledge this has been reported only five times previously. We present the case of a 60-year-old man involved in a motor vehicle accident who suffered an atlantooccipital dislocation and C5-C6 three-column injury. A unique MRI image of a defect in the ventral dura posterior to C2 was appreciated. He underwent occiput to T2 internal fixation and arthrodesis. During surgery, CSF egress was seen caudal to the right C2 nerve root. A DuraMatrix onlay patch reinforced with DuraSeal was placed to stop the CSF leak. A lumbar subarachnoid drain was also placed. The patient made a satisfactory recovery with residual mild weakness of his right upper extremity. In this report, we demonstrate that careful MRI review can reveal a ventral durotomy in a traumatic atlantooccipital dislocation and, if discovered, effective treatment including a lumbar subarachnoid drain for CSF diversion may prevent progression to a retropharyngeal pseudomeningocele. The literature on this rare presentation and associated durotomy is provided.

scholarly journals Navigation-Assisted Posterior Open Reduction and Internal Fixation in a C-CLAMP Fashion for an Isolated C1 Fracture

2020 ◽  
Author(s):  
Daniele Starnoni ◽  
Timo Ecker ◽  
Juan Barges-Coll
Keyword(s):  
Neck Pain ◽  
Internal Fixation ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Lateral Displacement ◽  
Lateral Mass ◽  
Transverse Ligament ◽  
Alar Ligament ◽  
The Right

AbstractC1 fractures with an intact transverse ligament are usually treated conservatively. Patients who present with a progressive diastasis of bone fragments and a progressive articular subluxation mainly attributed to progressive lengthening of the transverse ligament (TAL) fibers can be treated with a C1 “C-clamp” fusion.A 75-year-old male who sustained a motor vehicle accident was neurologically intact. A computed tomography (CT) imaging demonstrated a Jefferson's type-C1 fracture with a slight lateral displacement of the C1 left lateral mass (LM) and a rotatory subluxation on the right. MRI showed an intact TAL and demonstrated an isolated rupture of the left alar ligament. Conservative treatment was chosen. Radiographic follow-up showed, at 3 months, progressive lateral mass displacement, most likely due to elongation of the TAL fibers; this was also associated with a persistent mechanical neck pain. For this reason, we performed a posterior reduction and internal fixation in a C-clamp fashion by placement of C1 lateral mass screws and posterior compression sparing the C1–2 joint. Using navigation, a 3.5-mm screw was inserted into the LM bilaterally. The screw heads were then connected with a rod and compression was applied before tightening. Postoperative CT scan demonstrated a satisfying reduction and further imaging will be made during the follow-up. The patient had a considerable relief of neck pain. Simple lateral mass fixation with C-clamp technique is a reasonable option in case of isolated C1 fractures in patients who have failed conservative management while preserving the range of motion (ROM) at the atlanto–axial joint.The link to the video can be found at: https://youtu.be/x8bsVwzCt_M.

scholarly journals O4B.2 Patterns and predictors of return to work after major trauma: a prospective, population based registry study

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A34.2-A34
Author(s):  
Alex Collie ◽  
Pamela Simpson ◽  
Peter Cameron ◽  
Shanthi Ameratunga ◽  
Jennie Ponsford ◽  
...  
Keyword(s):  
Return To Work ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Multinomial Logistic Regression ◽  
Traumatic Injury ◽  
Population Based ◽  
Full Time ◽  
Post Injury ◽  
Targeted Interventions ◽  
Co Morbidity

BackgroundEmployment is an important marker of functional recovery from injury. There are few population-based studies of long-term employment outcomes, and limited data on the patterns of return to work post injury.ObjectivesThis study sought to characterise patterns of engagement in work over the four-year period following major traumatic injury, and to identify factors associated with those patterns.MethodWe conducted a population-based, prospective cohort study using the Victorian State Trauma Registry. A total of 1086 working age individuals, in paid employment or full-time education before injury, were followed-up through telephone interview at 6, 12, 24, 36, and 48 months post-injury. Responses to return to work (RTW) questions were used to define four discrete patterns: early and sustained; delayed; failed; no RTW. Predictors of RTW patterns were assessed using multivariate multinomial logistic regression.ResultsSlightly more than half of respondents (51.6%) recorded early sustained RTW. A further 15.5% had delayed and 13.3% failed RTW. One in five (19.7%) did not RTW. Compared with early sustained RTW, predictors of delayed and no RTW included being in a manual occupation and injury in a motor vehicle accident. Older age and receiving compensation predicted both failed and no RTW patterns. Pre-injury disability was an additional predictor of failed RTW. Presence of co-morbidity was an additional predictor of no RTW.ConclusionsA range of personal, occupational, injury, health and compensation system factors influence RTW patterns after serious injury. Early identification of people at risk for delayed, failed or no RTW is needed so that targeted interventions can be delivered.

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