Traumatic J-Pouch Perforation following a Blunt Abdominal Injury

A 46-year-old male was admitted to the trauma department after a motor vehicle accident. He presented with severe abdominal pain and a distended abdomen with peritonitis. His past surgical history included total proctocolectomy with ileal J-pouch anal anastomosis for ulcerative colitis 20 years previously. Computed tomography showed free peritoneal air and fluid in the abdomen mandating an exploratory laparotomy. A perforation at the ileal J-pouch blind end was found. Primary closure with diverting loop ileostomy was performed. The patient had an uneventful recovery and underwent closure of the ileostomy two months later. The case and management are discussed after reviewing the literature.

Download Full-text

Positive Seatbelt Sign with Avulsed Leiomyoma following Motor Vehicle Accident Leading to Hemoperitoneum

Case Reports in Emergency Medicine ◽

10.1155/2018/4251408 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Martin A. C. Manoukian ◽

Amode R. Tembhekar ◽

Sarah E. Medeiros

Keyword(s):

Motor Vehicle ◽

Motor Vehicle Accident ◽

Incidental Finding ◽

Major Complication ◽

Exploratory Laparotomy ◽

Fresh Frozen Plasma ◽

Reproductive Age ◽

Packed Red Blood Cells ◽

Vehicle Accident ◽

Increased Risk

A positive seatbelt sign following a motor vehicle accident is associated with an increased risk of intra-abdominal injury and hemoperitoneum. Injury to the uterus in reproductive-age women can also occur. In this report, we describe a 29-year-old nulligravida female who presented to the emergency room following a motor vehicle accident at freeway speeds. A positive seatbelt sign was noted, and a focused assessment with sonography for trauma revealed hemoperitoneum with an incidental finding of uterine leiomyomata. Upon exploratory laparotomy, a free-floating intraperitoneal mass was identified as an avulsed uterine leiomyoma. A uterine laceration containing a subserosal leiomyoma was also identified. The gynecological team was consulted, and a myomectomy of the subserosal leiomyoma followed by a closure of the uterine laceration was performed. The patient was transfused with a total of three units of packed red blood cells and two units of fresh frozen plasma. The postoperative course was without major complication. A positive seatbelt sign and hemoperitoneum in a reproductive-age woman with leiomyomata should increase the clinical suspicion for uterine injury and decrease the threshold for obtaining a gynecological consultation.

Download Full-text

Trauma in Pregnancy : Diversifying Obstetric Retrieval Service in Sabah

10.14293/s2199-1006.1.sor-.ppdcr6i.v1 ◽

2021 ◽

Author(s):

C. Arrchana Chandrasegaran ◽

Phee Kheng Cheah ◽

Arif Johari ◽

Muhamad Yaakub Ariffin ◽

Fatin Salwani Zaharuddin

Keyword(s):

Motor Vehicle ◽

Motor Vehicle Accident ◽

District Hospital ◽

Exploratory Laparotomy ◽

Well Being ◽

Vehicle Accident ◽

Retrieval Team ◽

Mode Of Transportation ◽

Trauma In Pregnancy ◽

Case Basis

The Obstetric and Gynaecological Retrieval Service in West Coast Sabah has been well-established since year 2015, parallel to the global advancement of Emergency Retrieval Service. The decision to transfer a patient or to deploy team to the patient lies in the hands of Retrieval Unit. Additionally the mode of transportation, surgeon availability, weather and travel time have to be taken into account. Even though the structure of the program is steadfast in diversifying retrieval services, there are still insufficient studies available to decide its worth. We report a case of a 19-year old primigravida at 27 weeks; involved in a high-impact motor vehicle accident and sustained class 4 hemorrhagic shock. Evaluated in a district hospital, uterine rupture was diagnosed. Hence, the dilemma was either to deploy a team to perform the surgery in district hospital, or to put the patient through a perilous journey back. We would discuss on how we had organised and coordinated a team of obstetrician and anaesthesiologist, along with the Retrieval Team, to perform an Emergency Exploratory Laparotomy in district hospital. Nevertheless, the best method of care is still debatable as astute judgement is crucial and this approach has to be taken on a case to case basis. Ultimately, the patients well-being is the utmost priority.

Download Full-text

Open label trial of escitalopram in motor vehicle accident survivors with posttraumatic stress disorder

PsycEXTRA Dataset ◽

10.1037/e516222012-037 ◽

2010 ◽

Author(s):

R. Coronas ◽

M.G. del Alamo ◽

H.G. Arnau ◽

E.I. Soto ◽

D. Suarez

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Open Label ◽

Vehicle Accident ◽

Open Label Trial

Download Full-text

Virtual reality and computer games in the treatment of driving phobia induced by a motor vehicle accident

PsycEXTRA Dataset ◽

10.1037/e705482011-064 ◽

2003 ◽

Author(s):

David Walshe ◽

Elizabeth Lewis ◽

Kathleen O'Sullivan ◽

Brenda K. Wiederhold ◽

Sun I. Kim

Keyword(s):

Virtual Reality ◽

Computer Games ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Vehicle Accident

Download Full-text

Expectations of lawyers with regard to neuropsychological evaluations in motor vehicle accident claims.

Professional Psychology Research and Practice ◽

10.1037/pro0000311 ◽

2020 ◽

Vol 51 (6) ◽

pp. 642-648

Author(s):

Henk Johan Swanepoel ◽

Esmé Van Rensburg

Keyword(s):

Motor Vehicle ◽

Motor Vehicle Accident ◽

Vehicle Accident ◽

Neuropsychological Evaluations

Download Full-text

Machine Learning of Motor Vehicle Accident Categories from Narrative Data

Methods of Information in Medicine ◽

10.1055/s-0038-1634680 ◽

1996 ◽

Vol 35 (04/05) ◽

pp. 309-316 ◽

Cited By ~ 4

Author(s):

M. R. Lehto ◽

G. S. Sorock

Keyword(s):

Machine Learning ◽

Bayesian Model ◽

Keyword Search ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Computer Search ◽

Vehicle Accident ◽

Learning Technique ◽

Expert Ratings ◽

Keyword Searches

Abstract:Bayesian inferencing as a machine learning technique was evaluated for identifying pre-crash activity and crash type from accident narratives describing 3,686 motor vehicle crashes. It was hypothesized that a Bayesian model could learn from a computer search for 63 keywords related to accident categories. Learning was described in terms of the ability to accurately classify previously unclassifiable narratives not containing the original keywords. When narratives contained keywords, the results obtained using both the Bayesian model and keyword search corresponded closely to expert ratings (P(detection)≥0.9, and P(false positive)≤0.05). For narratives not containing keywords, when the threshold used by the Bayesian model was varied between p>0.5 and p>0.9, the overall probability of detecting a category assigned by the expert varied between 67% and 12%. False positives correspondingly varied between 32% and 3%. These latter results demonstrated that the Bayesian system learned from the results of the keyword searches.

Download Full-text

Aspirated teeth - rigid or flexible bronchoscopy

Journal of Clinical Case reports and reviews ◽

10.36879/jccrr.19.000132 ◽

2019 ◽

pp. 1-2

Keyword(s):

Clinical Practice ◽

Foreign Bodies ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Flexible Bronchoscopy ◽

Vehicle Accident

Tracheobronchial foreign bodies are a common problem in clinical practice. We present the case of a patient with three aspirated teeth following a motor vehicle accident.

Download Full-text