Laparoscopic Repair of Diaphragmatic Rupture: A Case Report with Radiological and Surgical Correlation

The leading cause of diaphragmatic rupture is penetrating abdominal trauma, including gunshot- and stab-related wounds; however, diaphragmatic rupture can also result from blunt trauma to the abdomen. The diagnosis can be difficult to make as the physical examination may be unremarkable, and imaging, that is, a conventional chest X-ray and/or CT imaging, may initially fail to reveal the injury. Failure to recognize diaphragmatic rupture can result in a delayed presentation, sometimes years later, with a potential catastrophic outcome. Therefore, prompt and swift diagnosis is critical to avoid this potential harmful scenario. Traditionally, repair is performed through a laparotomy or a thoracotomy incision. Owing to the many advances made in minimally invasive surgery, not only has laparoscopy become the modality of choice to diagnose diaphragmatic rupture due to its high degree of sensitivity and specificity, but it can provide simultaneous therapeutic intervention as well. We report a case of laparoscopic repair of a diaphragmatic rupture in a 22-year-old female who sustained blunt abdominal trauma during a motor vehicle accident.

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Traumatic gastric rupture following blunt abdominal trauma: a case report about an atypical modality of presentation

Emergency Care Journal ◽

10.4081/ecj.2017.6609 ◽

2017 ◽

Vol 13 (1) ◽

Author(s):

Dario Giambelluca ◽

Dario Picone ◽

Natalino Carmelo Pennisi ◽

Bruno Luciani ◽

Giuseppe Lo Re ◽

...

Keyword(s):

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Rare Presentation ◽

Operative Morbidity ◽

Mortality And Morbidity ◽

Vehicle Accident ◽

Gastric Rupture ◽

History Of

Gastric rupture following blunt abdominal trauma is a rare presentation with a reported incidence of 0.02-1.7% in current literature. Traumatic gastric rupture is usually associated with other visceral injuries, such as splenic lesions and fractures. Prompt diagnosis and early intervention reduce mortality and morbidity. History of a recent meal has been implicated in traumatic gastric rupture. 2 We report a case of blunt abdominal trauma with an isolated gastric rupture after a motor vehicle accident, managed successfully without any post-operative morbidity and mortality.

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Delayed Management of Unrecognized Bilateral Temporomandibular Joint Dislocation: A Case Report

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0037-1601862 ◽

2018 ◽

Vol 11 (2) ◽

pp. 145-149

Author(s):

SiokYoong Chin ◽

Nazer Bin Berahim ◽

Khairulzaman Bin Adnan ◽

Sundrarajan Naidu Ramasamy

Keyword(s):

Temporomandibular Joint ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Masticatory Muscles ◽

Delayed Presentation ◽

Intermaxillary Fixation ◽

Vehicle Accident ◽

Tmj Dislocation ◽

Satisfactory Outcome ◽

Tissue Changes

Temporomandibular joint (TMJ) dislocation is a common occurrence, but diagnosis can be missed if patients do not complain. Delayed presentation complicates the management of a straightforward reduction. We present a case of a 24-year-old man who had bilateral TMJ dislocation of unknown duration after motor vehicle accident. The accident left him bedridden with speech difficulty. He was totally dependent on Ryles’ and percutaneous endoscopic gastrotomy tubes for feeding. Computed tomography revealed dislocation of condyles anterior to articular eminences. The bilateral TMJ dislocations were reduced surgically via bicoronal with preauricular extension approaches. However, the surgery was challenging due to tissue changes around the joint accompanied by masticatory muscles atrophy. Postoperatively, he was placed on intermaxillary fixation for 2 weeks followed by elastics training. Three months later, the patient's mastication returned completely to function. Delayed management of bilateral TMJ dislocation is undoubtedly challenging and somewhat frustrating; nevertheless, we manage to achieve satisfactory outcome in improving the patient's quality of life.

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Seatbelt: A Double-Edged Sword

Case Reports in Pediatrics ◽

10.1155/2012/326936 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3

Author(s):

P. Raychaudhuri ◽

N. K. Cheung ◽

C. Bendinelli ◽

M. Puvaneswary ◽

R. Ferch ◽

...

Keyword(s):

Blunt Trauma ◽

Vascular Injury ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Rapid Identification ◽

Mesenteric Vein ◽

Correct Placement ◽

Vehicle Accident ◽

Vein Injury ◽

High Degree

Intra-abdominal vascular injury due to blunt trauma is unusual in children. Due to its rarity, detailed reports dealing with its management are scarce in paediatric literature. Diagnosis of these injuries is challenging, and a high degree of awareness is necessary for rapid identification and treatment of these injuries. We report the case of a child with seatbelt sign and mesenteric vein injury due to blunt trauma to the abdomen during a motor vehicle accident where the seatbelt was incorrectly placed. She also sustained cervical vertebral injury. The pattern of injuries in children in these situations may differ from that found in adults. While seatbelts have undoubtedly saved many lives, awareness about correct placement of these restraints is extremely necessary.

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Challenges in management of blunt abdominal trauma: a prospective study

International Surgery Journal ◽

10.18203/2349-2902.isj20184078 ◽

2018 ◽

Vol 5 (10) ◽

pp. 3298

Author(s):

Rajkumar P. N. ◽

Kushal Kumar T. R. ◽

Deepak G.

Keyword(s):

Prospective Study ◽

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Imaging Modality ◽

Tertiary Care ◽

Organ Injury ◽

Solid Organ ◽

Vehicle Accident

Background: Trauma meets the pandemic criteria, with a daily worldwide mortality as high as 16000. Abdominal trauma remains a leading cause of mortality in all age groups. Blunt abdominal trauma (BAT) mainly results from motor vehicle accident, fall from height and assaults. The commonest organ injured is the spleen, followed by the liver and small bowel. Lately, the management of BAT has changed from operative to non-operative management. This study was done to analyse the incidence, patterns, current management practiced, and challenges encountered in BAT treated operatively.Methods: This Prospective study was conducted in tertiary care centre in Bangalore during August 2015 to December 2017. 475 patients with blunt abdominal injuries who reported to emergency department were selected for the study based on following inclusion and exclusion criteria.Results: A total of 475 cases of BAT were assessed with a mean age of males and females was 32.6 and 28.3year respectively. Most patients (65%) were between 21 to 30 years of life. Most common mode of injury was motor vehicle accident (57.68%), 60% patients presented to hospital within the initial 4 hours. Abdominal CT had highest accuracy. Most common solid organ injury being spleen (26.5%). 80.84% patients were selected for SNOM and 15.62% had Failed SNOM. 28.48% patients had complications with most common complication wound infection followed by aspiration pneumonia and 7 patients had mortality.Conclusions: Initial resuscitation with thorough clinical examination with correct usage of imaging modalities with timely and proper decision making is the key of management of patients with BAT and there is a need to identify newer imaging modality/procedure which helps to determine better management scheme in all blunt trauma patients.

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Profile of Abdominal Trauma Patient Underwent Surgery in Emergency Operating Room of Sanglah General Hospital from January until December 2015

JBN (Jurnal Bedah Nasional) ◽

10.24843/jbn.2018.v02.i01.p01 ◽

2018 ◽

Vol 2 (1) ◽

pp. 1

Author(s):

Reza Halim ◽

Made Agus Dwianthara Sueta

Keyword(s):

General Hospital ◽

Operating Room ◽

Abdominal Trauma ◽

Medical Records ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Trauma Patients ◽

Vehicle Accident ◽

Liver Repair ◽

Emergency Operating

Objective: to investigate the characteristics of patients, presentation of the abdominal organ that involved, and clinical data associated with this event. Methods: this is a descriptive study with retrospective design. Total samples were all patients with abdominal trauma who underwent surgery on the emergency operating theatre of Sanglah General Hospital between January and December 2015. Baseline data of patients were obtained from the medical records. Results: within the study period, a total of 104 patients with abdominal trauma who underwent surgery in the emergency operating room of Sanglah General Hospital were identified. Man comprised 87.5% of the patients and mostly were 17-45 years old (75%). The motor vehicle accident occurred majority on the weekend (65%). Liver and spleen were the most affected organ (55%). Splenectomy (35%) and liver repair surgery (33%) were the most often performed procedures. Conclusion: Abdominal trauma caused by motor vehicle accident occurred mostly on the weekend. Two most affected organs in abdominal trauma were liver and spleen. Splenectomy and liver repair surgery were the procedures performed for these trauma patients.

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Motor Vehicle Accident and Alarming Chest X-ray

Pediatric Emergency Care ◽

10.1097/01.pec.0000136077.68069.7d ◽

2004 ◽

Vol 20 (8) ◽

pp. 551-552

Author(s):

Leonard E. Swischuk

Keyword(s):

Motor Vehicle ◽

Motor Vehicle Accident ◽

X Ray ◽

Vehicle Accident ◽

Chest X Ray

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Blunt abdominal trauma in Sanglah Hospital Bali, Indonesia: a study of 65 cases

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20193951 ◽

2019 ◽

Vol 7 (9) ◽

pp. 3575

Author(s):

Putu Gosen Partama ◽

Made Agus Dwianthara Sueta

Keyword(s):

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Hypovolemic Shock ◽

Organ Damage ◽

Retroperitoneal Haematoma ◽

Common Cause ◽

Vehicle Accident ◽

Common Clinical Presentation

Abdominal trauma is a challenge for every surgeon, whether related to diagnosis or treatment. In developing countries, the number of traumatic events associated with death makes it necessary for a study to be carried out to see the patterns and damage caused by abdominal trauma and the organs involved. Material and Method is all patients with blunt trauma of the abdomen who came to emergency unit Sanglah Hospital Bali, from January 2017 up to May 2018 that undergo laparotomy exploration were enrolled, the data were collected retrospectively using patient medical records. Results is 65 patients with blunt abdominal trauma came to the emergency department and undergoes laparotomy exploration, range of age was 4-74 year old and 75.3% of them were men. The most common injured organs were spleen and liver, both are 26 and 15 cases (40 and 23%). Another intraoperative finding are Ileum Perforation (10 cases) Left Zone II Retroperitoneal Haematoma (7 cases), and Mesenterium Rupture (5 cases). Splenectomy was the most performed procedure (26 cases). The most common cause of blunt abdominal trauma was motor vehicle accident. Hypovolemic shock was the most common clinical presentation (48 patient). The Conclusions are according to this study, men consisted 75.3% cases of blunt abdominal trauma and the range age of patients was 4-74 year old. The most common cause was motor vehicle accident. Among patients with intra-abdominal organ damage, spleen and liver were most commonly involved. About 84.6% of all patients with blunt abdominal trauma were discharged without complication and morbidity.

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