Isolated Chyle Duct Injury in Blunt Trauma

We present a case of a patient sustaining an isolated injury to the right main branch of the cysterna chyli due to a high-speed motor vehicle accident. A 42-year-old man presented after a high-speed collision. CT revealed a collection of hypodense fluid in the gallbladder fossa, which was the clue to take him to the OR. We proceeded to laparoscopic exploration, and based on the milky white color of the fluid, identified a chyle leak. In an open fashion, the retroperitoneum was explored and the injury was identified as disruption of the right lumbar branch entering the cisterna chyli, and this was ligated with silk ties. Chyle duct injury secondary to blunt trauma is a rare finding. The use of CT imaging can identify this injury. Laparoscopy can confirm the injury. Open ligation of the injured duct is the best treatment.

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Humeral Head Fracture with Intrathoracic Migration

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1016/j.jotr.2017.01.002 ◽

2018 ◽

Vol 24 (1) ◽

pp. 57-59

Author(s):

Caggiari Gianfilippo ◽

Mosele Giulia Raffaella ◽

Puddu Leonardo ◽

Spiga Mauro ◽

Doria Carlo

Keyword(s):

Humeral Head ◽

High Speed ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Surgical Excision ◽

Symphysis Pubis ◽

Fracture Dislocation ◽

Vehicle Accident ◽

Total Body ◽

The Right

Fracture-dislocation of the humeral head with intrathoracic migration is extremely rare. In our study we describe the case of a 23-year-old man who was admitted to the emergency clinic of our hospital, after being injured in a high-speed motor vehicle accident. The patient presented in a state of hemorrhagic shock and severe respiratory disease. Chest radiography showed fracture of the right humeral head and the presence of a round radio-density area resting on the diaphragm right hemithorax. The total body computed tomography scan revealed a right pneumothorax related to the presence in the chest cavity of the fractured humeral head, longitudinal fracture of the sacrum, and diastasis of the symphysis pubis. After an initial hemodynamic stabilization the patient underwent surgical excision of the humeral head and its replanting. It is important after airway management and the use of diagnostic imaging, the treatment of any injuries associated with the trauma.

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Pediatric Traumatic Retroclival Epidural Hematoma

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100011550 ◽

2011 ◽

Vol 38 (2) ◽

pp. 338-340 ◽

Cited By ~ 6

Author(s):

Cameron M. McDougall ◽

Tejas Sankar ◽

Vivek Mehta ◽

Jeffrey A. Pugh

Keyword(s):

Glasgow Coma Score ◽

High Speed ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Upper Cervical Spine ◽

Mandibular Fractures ◽

Front Seat ◽

Vehicle Accident ◽

Upper Cervical ◽

The Right

A previously healthy ten-year-old girl was involved in a high speed motor vehicle accident (MVA) in which she was the belted front-seat passenger. The patient's teeth marks on the dashboard were evidence of a high-velocity impact. Her Glasgow Coma Score on scene was 13, and she was amnestic for the event. She was subsequently transported to the emergency room in full spinal precautions; on arrival she was hemodynamically stable with a Glasgow Coma Score of 14, complaining of neck and jaw pain. Neurological examination revealed impaired abduction of the right eye, with no other focal deficits. She had oral lacerations and bruising over the mandibles bilaterally.Computed tomogram (CT) scan of the head was initially interpreted as normal, but on closer inspection demonstrated a 4mm retroclival hematoma (Figure 1). Sagittal CT through the upper cervical spine revealed the hematoma was epidural, bounded by the spheno-occipital synchondrosis superiorly and by the mid-body of the axis inferiorly (Figure 2). The odontoid was retroflexed (Figure 2). Bilateral mandibular fractures were also uncovered on facial imaging.

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Traumatic cataract secondary to blunt trauma in motor vehicle accident

Visual Journal of Emergency Medicine ◽

10.1016/j.visj.2017.01.016 ◽

2017 ◽

Vol 8 ◽

pp. 3-4

Author(s):

Brian C. Fiore ◽

Nicolay F. Hernandez ◽

Jeffrey Lazar

Keyword(s):

Blunt Trauma ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Traumatic Cataract ◽

Vehicle Accident

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

Case Reports in Surgery ◽

10.1155/2015/361764 ◽

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.

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Radiography is less sensitive relative to CT for detecting thoracic radiographic changes in dogs affected by blunt trauma secondary to a motor vehicle accident

Veterinary Radiology & Ultrasound ◽

10.1111/vru.12795 ◽

2019 ◽

Vol 60 (6) ◽

pp. 648-658 ◽

Cited By ~ 1

Author(s):

Sumari C. Dancer ◽

Christelle Le Roux ◽

Geoffrey T. Fosgate ◽

Robert M. Kirberger

Keyword(s):

Blunt Trauma ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Vehicle Accident ◽

Radiographic Changes

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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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Probability Analysis of Motor Vehicle Accidents

Design Engineering ◽

10.1115/imece2002-32957 ◽

2002 ◽

Cited By ~ 2

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.

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Posttraumatic Transdiaphragmatic Intercostal Hernia: Report of a Case and Review of the Literature

International Surgery ◽

10.9738/intsurg-d-13-00272.1 ◽

2015 ◽

Vol 100 (3) ◽

pp. 444-449 ◽

Cited By ~ 6

Author(s):

Vasileios Kalles ◽

Maria Dasiou ◽

Georgia Doga ◽

Ioannis Papapanagiotou ◽

Evangelos A Konstantinou ◽

...

Keyword(s):

Surgical Repair ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Thoracic Wall ◽

Hernia Sac ◽

Vehicle Accident ◽

Intercostal Hernia ◽

Area 6 ◽

The Right ◽

Transdiaphragmatic Intercostal Hernia

Intercostal hernias are rare, and usually occur following injuries of the thoracic wall. The scope of this report is to present a case of a 53-year-old obese patient that developed a transdiaphragmatic intercostal hernia. The patient presented with a palpable, sizeable, reducible mass in the right lateral thoracic wall, with evident bowel sounds in the area, 6 months after a motor-vehicle accident. On computed tomography (CT), the hernia sac contained part of the liver and part of the ascending colon. A surgical repair of the defect was performed, using a prosthetic patch. The patient's postoperative course was uneventful and she remains recurrence free at 12 months after surgery. Intercostal hernias should be suspected following high-impact injuries of the thoracic wall, and CT scans will facilitate the diagnosis of intercostal hernia. We consider the surgical repair of the defect, with placement of a prosthetic mesh, as the treatment of choice to ensure a favorable outcome.

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Isolated Intrathoracic Injury with Air Bag Use

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00042011 ◽

1995 ◽

Vol 10 (3) ◽

pp. 198-201 ◽

Cited By ~ 4

Author(s):

Andrew E. Sama ◽

Douglas P. Barnaby ◽

Kevin J. Wallis ◽

Dominick Gadaleta ◽

Michael H. Hall ◽

...

Keyword(s):

Thoracic Aorta ◽

High Speed ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

High Index ◽

Vehicle Accident ◽

Air Bag ◽

High Index Of Suspicion ◽

External Injury

AbstractThe restrained (air bag and seatbelt) driver of a vehicle involved in a high-speed motor-vehicle accident sustained a tear of the thoracic aorta with no signs of external injury. Air bag deployment may mask significant internal injury, and a high index of suspicion is warranted in such situations.

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