scholarly journals Gunshot Wound of the Thoracic Aorta with Right Popliteal Artery Embolization: A Case Report of Bullet Embolism with Review of Relevant Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Saptarshi Biswas ◽  
Hadley Cadot ◽  
Sunil Abrol

Bullet embolism is a well-known but relatively uncommon complication of gunshot injuries. Their rarity and the potential lack of early symptoms lead to delays in diagnosis and often in inadequate early management that can potentially result in the loss of a limb or life. We present an interesting case in which a small caliber bullet to the upper anterior abdomen penetrated the thoracic aorta and traveled to the right popliteal artery embolizing the vessel. The exploratory laparotomy failed to locate neither the bullet nor the trajectory resulting in sudden deterioration and eventual death 5 hours into the postoperative period.

Author(s):  
Saptarshi Biswas ◽  
Nishaan Nagarakanti

ABSTRACT Traumatic iliac vessel injuries, especially secondary to penetrating wounds, are often associated with a very high mortality rate. The patients usually present to the trauma bay in profound hemorrhagic shock, which, in turn, triggers the vicious cycle of hypothermia, coagulopathy, and acidosis. Iliac artery injuries should be managed promptly because of the high incidence of late complications of pseudoaneurysm and arteriovenous fistulae and risks of subsequent arterial thrombosis and distal ischemia. We report a case of a 17-year-old female who was brought in following a stab wound in the right lower quadrant (RLQ). A postlaparotomy computed tomography (CT) scan performed revealed a pseudoaneurysm on the right common iliac. A pelvic angiography was performed, which was followed by an endovascular placement of a covered stent on the right common iliac artery. We discuss an interesting case along with discussion of relevant literature. How to cite this article Biswas S, Nagarakanti N. Endovascular Stenting for Traumatic Common Iliac Pseudoaneurysm as an Adjunct following Exploratory Laparotomy in a Stab Injury Patient. Panam J Trauma Crit Care Emerg Surg 2016;5(3):172-176.


2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Arvind Sharma ◽  
Adarsh Kumar ◽  
Sheikh Imran ◽  
Pankaj Sood ◽  
Rajesh Kumar Asrani

The objective of this case report was to describe the ultrasonographic, surgical, and histopathological findings of a rare clinical case of uterine leiomyoma in a 5-year-old Holstein crossbred cow presented for diagnosis and treatment of infertility. Transrectal palpation revealed a large nonpainful mass suspected to be an abscess or a tumor in the caudal abdomen on the right side. Transabdominal ultrasonography revealed a round mass with irregular hypoechogenic/echogenic foci and a thin echogenic capsule around it. Ultrasonographic-guided centesis of the lesion under local analgesia did not yield any foul smelling aspirate leading to a tentative diagnosis of an intra-abdominal tumor. The lesion was later confirmed by exploratory laparotomy and histopathology as a case of uterine leiomyoma. The cow gave birth to a live normal calf 12 months following the surgery. Rectal examination after parturition revealed no evidence of the tumor at the surgical site. Ultrasonography enabled prompt, noninvasive diagnosis of uterine leiomyoma and proved to be a useful decision-making tool in the abdominal surgery of the cow. This is an interesting case which broadens the spectrum of the causes of infertility in cattle.


VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Gruber-Szydlo ◽  
Poreba ◽  
Belowska-Bien ◽  
Derkacz ◽  
Badowski ◽  
...  

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.


2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1477-1481
Author(s):  
Ishwari Gaikwad ◽  
Priyanka Shelotkar

The current world situation is both frightening and alarming due to the massive disruption caused by the Covid-19 pandemic. The next few days are censorious as we need to be very precautious in our daily regimen as well as dietary habits. Ayurveda offers knowledge about food based on certain reasoning. Indecent food custom is the chief cause for the rising development of health disorders in the current era. In classical texts of Ayurveda, the concept of diet explained well, ranging from their natural sources, properties and specific utility in pathological as well as physiological manner. In this work, the review of the relevant literature of Ahara (Diet) was carried out from Charak Samhita and other texts, newspapers, articles, web page related to the same.  Every human being is unique with respect to his Prakriti (Physical and mental temperament), Agni (Digestive capacity), Koshtha  (Nature of bowel) etc. For that reason, the specificity of the individual should be kept in mind. Ahara, when consumed in the appropriate amount at the right moment following all Niyamas (Guidelines) given in Ayurveda texts, gives immunity and keeps the body in a healthy state during pandemics such as Covid-19. Ultimately, this will help the human body to maintain its strength for life. This article reviews the concept of diet viz. combination of foods, their quantity and quality, methods of preparation and processing, which are to be followed during pandemics and are essential in maintenance and endorsement of health and preclusion of diseases.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Swamad ◽  
M K Quraishi ◽  
S Ahmed

Abstract We present an interesting case of a 70-year-old female who presented with haematuria on the suspected cancer pathway. Renal ultrasound showed a vascular renal mass on her right kidney measuring 8x7cm with an unremarkable left kidney. She underwent a laparoscopic radical nephrectomy following confirmation of an 8cm renal mass in the right kidney on the contrasted staging CT scan with a repeat review at the multidisciplinary meeting. Post-operatively a subsequent review of the pre-operative CT and ultrasound scan, showed an incidental large left(contralateral) upper quadrant retroperitoneal fatty mass sized 15x10cm, displacing the stomach and spleen. Further investigation in the form of an MRI Abdomen excluded features of a liposarcoma, resulting in the diagnosis of a large retroperitoneal lipoma. This case highlights the significance of selective attention in imaging interpretation. We believe this to be a prime example of the level of meticulousness required as fat-rich tissues have low attenuation on CT-scans, which can be easily missed out. A cautious multi-clinician interpretation of scans should be performed to avoid missing potentially sinister pathology which would impact patient care dramatically. This case has led to more thorough review of future pre-operative imaging by the operating surgical team.


2016 ◽  
Vol 101 (3-4) ◽  
pp. 167-170
Author(s):  
Fatih Ciftci ◽  
Suat Benek ◽  
Cem Kezer

The acute abdomen has many etiologies frequently encountered in emergency surgical units. Approximately 20% of surgical admissions for acute abdominal conditions are for intestinal obstruction. Clinicians often overlook rarer causes. A 43-year-old man presented to the emergency ward with the clinical findings of ileus. Computed tomography revealed a heterogeneous necrotic 168 × 100-mm mass between the sigmoid colon and urinary bladder. Physical examination revealed a palpable intra-abdominal mass that was removed via exploratory laparotomy. On histopathologic examination, the mass was identified as a seminoma. The literature contains few reports of seminoma as a cause of acute abdomen and ileus, mostly seen between the ages of 30 and 40 years. We report a patient with seminoma arising in an undescended testis that presented as a palpable painful lower abdominal mass and mechanical intestinal obstruction, despite the large diameter of the mass, as well as review relevant literature.


2011 ◽  
Vol 35 (4) ◽  
pp. 87-125 ◽  
Author(s):  
Peter D. Feaver

President George W. Bush's Iraq surge decision in late 2006 is an interesting case for civil-military relations theory, in particular, the debate between professional supremacists and civilian supremacists over how much to defer to the military on decisions during war. The professional supremacists argue that the primary problem for civil-military relations during war is ensuring the military an adequate voice and keeping civilians from micromanaging and mismanaging matters. Civilian supremacists, in contrast, argue that the primary problem is ensuring that well-informed civilian strategic guidance is authoritatively directing key decisions, even when the military disagrees with that direction. A close reading of the available evidence—both in published accounts and in new, not-for-attribution interviews with the key players—shows that the surge decision vindicates neither camp. If President Bush had followed the professional supremacists, there would have been no surge because his key military commanders were recommending against that option. If Bush had followed the civilian supremacists to the letter, however, there might have been a revolt of the generals, causing the domestic political props under the surge to collapse. Instead, Bush's hybrid approach worked better than either ideal type would have.


Sociology ◽  
2021 ◽  
Author(s):  
Peter Kivisto

Conservatism refers to one of the constituent political positions found in all contemporary democracies. It can be construed as a philosophy, an ideology, a political party, a movement, a disposition, a mode of discourse, performance style, and an emotional relationship to the political. Since the birth of modern democracies in the aftermath of the French Revolution, it has become commonplace to describe the range of political options available to the citizenry as occupying a spectrum from left to right, with a range of alternatives between the extreme poles, including a centrist position in the middle that straddles the divide. The left was associated with promoting challenges to established authorities and existing hierarchies, along with calls for increased economic equality and expanded social and political rights to all citizens, including the heretofore marginalized. This contrasts with the right, which was defined as defending inequalities and differential entitlements, concentrating matters involving rights around preserving property rights, shoring up public and social order, and promoting traditional values and conventional social relations. In this context, liberalism became a mark of political identity associated with the left, as did socialism, while conservatism, broadly construed, represented the right. This framing of politics also includes the possibility of underminings by extremism on both the left and right. For the former, the main threat since the Russian Revolution has been posed by revolutionary communism, while right-wing extremism has manifested itself in reactionary movements, including fascism and illiberal populism. Since liberalism and conservatism must be understood in relational terms, the spatial and temporal settings for the politics of opposition will vary considerably. It is impossible to do justice to the vast literature on conservatism in a bibliography such as this. What follows is a more delimited, and thus manageable examination of work on conservatism. First, it focuses on conservatism in the United States, and not elsewhere. Second, it is chiefly concerned with conservatism since the end of World War II. Third, it concentrates on the study of conservatism by sociologists and those working in cognate disciplines; while not all the authors are card-carrying sociologists, their works reflect a sociological character, although the exception to this third point is the overview section, which presents key readings by advocates of conservatism, and thus offers insider depictions of the meaning of conservatism. Fourth, this article does not concentrate solely on extremist right-wing movements; rather, in surveying the relevant literature on American conservatism broadly construed, it points to a growing consensus that the radical right wing has pushed mainstream conservatism increasingly further to the right.


2021 ◽  
pp. 58-59
Author(s):  
Jayanta Sarkar ◽  
Mini Sengupta

Heterotopic pregnancy describes the occurrence of two or more pregnancies in different implantation sites simultaneously, intrauterine pregnancy coexists withectopic pregnancies (ampullary in 80%). A 27-year-old women (P ,L1) presented to the emergency department with a complaint of sudden onset of right-sided lower abdominal pain with 1+1 vaginal bleeding and had a short period of Amenorrhea. Ultrasonography demonstrated three intrauterine gestational sacwith foetal pole noted but Cardiac activity was absent . The right adnexa showed a heteroechoic area andmoderate amount of free uid was present in the lower abdominal cavity. Ectopic pregnancy was disturbed. An emergency exploratory laparotomy was performed under general anesthesia. Haemoperitoneum was found with a ruptured righttubal ectopic pregnancy as well. Both the ovaries appeared normaland a corpus luteal cyst was presentin right ovary. Right sided salpingectomy was performed with removal of the ectopic mass,heamostasis secured ,on table blood transfusion had been given.Suction evacuation had also been performed by manual vacuum aspirationon same sitting.Both the specimen send for histopathology. Histology conrmedGestational sac suggestive of an intra uterine pregnancy coexists with ectopic pregnancy. Left tube and both ovaries were found healthy. Episodes of PID also have a strong correlation with occurrence of ectopic gestation. Once diagnosis of heterotrophic pregnancy has been made the management is essentially surgical.


2021 ◽  
pp. 152660282110659
Author(s):  
Peyton Tharp ◽  
Ryan W. King ◽  
Bruce M. Frankel ◽  
Mathew D. Wooster

Purpose: Address iatrogenic injury to the descending thoracic aorta by breached spinal screws through a novel approach of concomitant spinal screw removal and thoracic endovascular repair (TEVAR) placement. Case Report: A 36-year-old female with idiopathic scoliosis underwent T4 to L3 bilateral pedicle instrumentation with spinal fusion and correction of scoliosis deformity. Ten months post-operative, she continued to complain of mid-thoracic pain; computed tomography (CT) angiography revealed protrusion of the left T5 and T6 transpedicular screws into her descending thoracic aorta by 3 and 5 mm, respectively. She was taken to the odds ratio (OR) in a combination case with vascular and neurosurgery. Positioned in the right lateral decubitus position, TEVAR was successfully deployed while neurosurgery concurrently removed the invading spinal screws via posterior spinal exposure. Neurosurgery then completely revised the spinal hardware during the same operation. The patient progressed well throughout the remainder of her hospital stay and was discharged on postoperative day 4. Two-year angiography demonstrated a well-placed TEVAR with no extravasation or aortic abnormality. Conclusions: In the setting of iatrogenic aortic injury due to pedicle screws, concomitant TEVAR and spinal screw removal is a safe and feasible treatment option that allows for spinal reconstruction to occur without multiple trips to the operating room.


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