Pencils and Pens: An Under-Recognized Source of Penetrating Injuries in Children

2011 ◽  
Vol 77 (8) ◽  
pp. 1076-1080
Author(s):  
Sarah B. Fisher ◽  
Matthew S. Clifton ◽  
Amina M. Bhatia
Keyword(s):  
Trauma Registry ◽  
Recent Literature ◽  
Surgical Intervention ◽  
Case Reports ◽  
Penetrating Trauma ◽  
Pediatric Hospital ◽  
Penetrating Injuries ◽  
Hospital System ◽  
Potential Risks ◽  
Home And School

Unlike other sharp objects, pens and pencils are readily available to children both at home and school. Although case reports are published, no series of pen or pencil injuries have been reported in the recent literature. We therefore reviewed the incidence and injury profiles of writing instruments as compared with other sources of penetrating trauma. The trauma registry from a large urban pediatric hospital system was queried for nonmissile, nonbite penetrating injuries from 2005 through 2009. Retrospective data was collected on demographics, injuries, operations, admissions, and mortalities. Additionally, data regarding pen and pencil injuries from 2009 to 2010 were collected prospectively, and one case from 2003 was included retrospectively. Fourteen injuries from writing instruments were seen and involved the head and neck (9), chest (1), bladder/perineum (2), and extremities (2). Eleven children were admitted and eight required surgical intervention. One child died from a transhemispheric brain injury after intraorbital penetration by a pencil. Penetrating trauma from writing instruments is not an uncommon source of injury and often requires surgical intervention to remove the object. Injuries from pens and pencils can be severe or even fatal. Appropriate parent and teacher education regarding the potential risks may help to prevent such injuries.

Penetrating abdominal trauma – selected case reports

2021 ◽  
Vol 100 (5) ◽  
Keyword(s):  
Recent Literature ◽  
Case Reports ◽  
The United States ◽  
Haemodynamic Instability ◽  
Postoperative Infections ◽  
Penetrating Injuries ◽  
Penetrating Abdominal Trauma ◽  
Blunt Force Trauma ◽  
Life Threatening ◽  
Penetrating Abdominal Injury

We present 3 case-reports with penetrating abdominal injury from our practice in this article. An urgent laparotomy was performed in all cases because of haemodynamic instability or the mechanism of injury. Penetrative abdominal traumas are associated with a high risk of life-threatening intra-abdominal injuries, require urgent revision and are often accompanied by postoperative infections of the peritoneal cavity. In recent years, there has been a growing tendency towards mini-invasive approaches or even non-operative treatment. This trend is particularly evident in the United States of America, where doctors experience a higher number of penetrating injuries compared to the prevalent blunt force trauma in Europe. The authors describe the need to follow all recommended procedures in the pre-hospital and hospital phases of treatment of these patients and compare them with recent literature.

scholarly journals Therapeutic Management of a Substantial Pelvic Aneurysmatic Bone Cyst Including the Off-Label Use of Denosumab in a 35-Year-Old Female Patient

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
D. Ntalos ◽  
M. Priemel ◽  
C. Schlickewei ◽  
D. M. Thiesen ◽  
J. M. Rueger ◽  
...  
Keyword(s):  
Monoclonal Antibody ◽  
Female Patient ◽  
Therapeutic Agent ◽  
Surgical Intervention ◽  
Case Reports ◽  
Bone Cyst ◽  
Off Label Use ◽  
Aneurysmal Bone Cysts ◽  
Promising Therapeutic Agent

Aneurysmal bone cysts (ABC) are benign bone tumors, which are highly vascularized. The main course of treatment is curettage followed by bone grafting or cement insertion. Still recurrence remains a main problem for patients. Denosumab is a monoclonal antibody, which acts as an inhibitor of the RANK/RANKL pathway, diminishing bone turnover. Recent case reports have shown that Denosumab can be a promising therapeutic agent for people suffering from therapy-resistant ABC. We report the case of a 35-year-old female patient presenting with a pronounced ABC of the pelvis. Since the tumor was inoperable, Denosumab was administered, leading to a significant shrinkage of the lesion, which allowed surgical intervention. Upon recurrence, Denosumab was restarted putting the patient once more into remission. Follow-up was four years overall with a clinical and radiological stable disease for fifteen months after final discontinuation of the monoclonal antibody. Therefore, our case further underlines the potential of Denosumab in the treatment of ABC.

Intracardiac Self Insertion of a Darning Needle in a Psychiatric Patient

2021 ◽  
Vol 4 (5) ◽  
pp. 01-13
Author(s):  
Avra Laarakker
Keyword(s):  
Left Ventricle ◽  
Psychiatric Patient ◽  
Surgical Intervention ◽  
Case Reports ◽  
Interventricular Septum ◽  
Intravenous Drug User ◽  
Standard Of Care ◽  
Pubmed Search ◽  
Needle Entry ◽  
The Right

Objective: We report a case of self inserted needle into the left ventricle of the heart and a description of our surgical intervention in a psychiatric patient without decision-making capacity. We discuss issues regarding obtaining consent in this patient with a sub-acute presentation, report our operative approach, and summarize a treatment approach based on a review of current literature. Methods: A PubMed search using terms “needle, “heart”, “insertion”, “intracardiac foreign object”, yielded 69 relevant papers. 67 of these were case reports yielding 72 individual cases. Age, gender, cause of the needle entry (Accidental Plus (A+), Intravenous Drug User [IVDU], Self-inflicted (SI)), type of needle, location in heart, neuropsychiatric history, treatment, and outcome were documented. Results: Within the SI category, there were a total of 28 cases, 89.3% had a neuropsychiatric history whereas only there were only 2 such patients in both the IVDU and A+ group. The location of the needle in the heart in all 72 cases was as follows: right ventricle 40.3%, other 20.8%, left ventricle 19.4 %, ventricle and interventricular septum 16.7% and the right and left atrium were each 1.4 %. In all three groups (n=72), 77.8% of patients underwent surgery, with 92.9% having a stable outcome. Conclusion: Our case and review demonstrates that management of such cases, particularly when active mental health issues are present, requires a case-by-case evaluation and treatment as a specific standard of care has not been established. Surgical intervention appears to be the preferred management regardless of presentation with good outcomes. Running Title: Intracardiac Self Insertion of a Darning Needle in a Psychiatric Patient

scholarly journals Segmental Arterial Mediolysis: An Under-Recognized Cause of Chronic Abdominal Pain

2020 ◽  
Author(s):  
Tulika Chatterjee ◽  
Johnathon Stephens ◽  
Moni Roy
Keyword(s):  
Abdominal Pain ◽  
Medical Management ◽  
Surgical Intervention ◽  
Case Reports ◽  
Healthcare Providers ◽  
Chronic Abdominal Pain ◽  
Segmental Arterial Mediolysis ◽  
The Past ◽  
Missed Diagnosis ◽  
Abdominal Arteries

Segmental arterial mediolysis (SAM) is a non-inflammatory, non-atherosclerotic vasculopathy mostly involving the abdominal arteries. SAM was recently recognized as a more prevalent aetiology of abdominal pain than initially thought by healthcare providers. It is still a commonly missed diagnosis in patients with recurrent emergency room (ER) visits for abdominal pain. Most published case reports in the past have highlighted catastrophic sequelae such as intra-abdominal haemorrhage requiring surgical intervention. We report a case of SAM where the diagnosis was initially missed. After diagnosis, conservative medical management was offered which led to clinical improvement.

scholarly journals PENETRATING TRAUMA OF BRACHIOCEPHALIC ARTERY LESION WITH EMBOLIZATION OF FOREIGN BODY TO RIGHT AXILLARY ARTERY IN PEDIATRIC PATIENT: CASE PRESENTATION AND HIS MANAGEMENT.

2020 ◽  
Author(s):  
Luis Zerpa Acosta ◽  
Jameel Al Ata ◽  
Alfredo Sanchez Gamboa ◽  
Elmahi Babikir ◽  
Abdullah Al Zahrani ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Surgical Repair ◽  
Axillary Artery ◽  
Median Sternotomy ◽  
Penetrating Trauma ◽  
Innominate Artery ◽  
Penetrating Injuries ◽  
Patient Case ◽  
Case Presentation ◽  
Great Vessels

ABSTRACT: BACKGROUND: Penetrating injuries of the intrathoracic great vessels are well recognized although uncommon in pediatric patients, management in pediatric patients presents challenges. Surgical repair by median sternotomy is the exposure of choice for accessing innominate artery injuries, but endovascular intervention in being increasingly introduced in the hemodynamically stable

scholarly journals Ocular dirofilariasis in practical ophthalmology

The Eye ◽  
2020 ◽  
Vol 22 (3(131)) ◽  
pp. 23-25
Author(s):  
T. A. Sharova
Keyword(s):  
Immune Response ◽  
Surgical Intervention ◽  
Clinical Course ◽  
Case Reports ◽  
Research Data ◽  
Medical Professionals ◽  
Parasitic Diseases ◽  
Host Parasite

Parasitic diseases of the eye are a widespread and poorly studied problem. This article is intended to systematize the possible mechanisms of infection and to determine the features of the clinical course and treatment of an ocular dirofilariasis. For this purpose, case reports and research data from medical professionals from Europe and Asia are presented. Conclusions were drawn regarding the dependence of the clinical course on the host  – parasite interaction and immune response and that the only applicable method of treatment in all the cases considered was surgical intervention.

Endocrine Tumors of the Appendix: A Pathologic Review

2010 ◽  
Vol 134 (6) ◽  
pp. 871-875
Author(s):  
Lydia Deschamps ◽  
Anne Couvelard
Keyword(s):  
Goblet Cell ◽  
Patient Management ◽  
Recent Literature ◽  
Surgical Intervention ◽  
Right Hemicolectomy ◽  
World Health ◽  
Endocrine Tumors ◽  
Management Guidelines ◽  
Pathologic Analysis ◽  
Health Organization

Abstract Context.—Although rare, appendiceal endocrine tumors are the most common neoplasms of the appendix. Pathologic analysis is important for guiding the management of patients. Objective.—To provide recent data that focus on the pathology of endocrine tumors of the appendix including classifications and guidelines for patient management. Data Sources.—A review of the recent literature including TNM classifications and patient management guidelines. Conclusions.—Appendiceal endocrine tumors are separated into 2 main groups: classic endocrine tumors and goblet cell carcinoids. They can be classified according to World Health Organization and TNM classifications. Evaluation of their prognoses and risks of malignancy, according to these classifications, depends on several parameters including tumor size, proliferation rate, and infiltration of appendiceal wall and mesoappendix. Most patients with classic endocrine tumors of the appendix have a favorable prognosis. Indications for postappendectomy, complementary surgery, which are still controversial, especially for tumors between 1 and 2 cm, are presented and discussed. In contrast, in patients presenting with a goblet cell carcinoid, a right hemicolectomy after the initial appendectomy is considered the standard surgical intervention.

Length of Nonoperative Treatment and Risk of Pleural Empyema in the Management of Pancreatitis-induced Pancreaticopleural Fistula

2013 ◽  
Vol 79 (6) ◽  
pp. 614-619 ◽  
Author(s):  
Michael Schweigert ◽  
Norbert Solymosi ◽  
Attila Dubecz ◽  
Dietmar Ofner ◽  
Hubert J. Stein
Keyword(s):  
Surgical Intervention ◽  
Nonoperative Management ◽  
Case Reports ◽  
English Literature ◽  
Fistulous Tract ◽  
Pleural Empyema ◽  
Nonoperative Treatment ◽  
Endoscopic Stenting ◽  
Septic Complications ◽  
Ascending Infection

Pancreaticopleural fistula is a very uncommon complication of pancreatitis resulting from pancreatic duct disruption with leakage of pancreatic secretions into the pleural cavity. Initial conservative treatment fails in a significant number of cases. Ascending infection through the fistulous tract results in pleural empyema. The aim of this study is to investigate the relation between lengths of nonoperative management and risk of pleural empyema. The retrospective study includes our own experience as well as all case reports identified by a systematic review of the English literature from 1954 to 2012. Inclusion criteria were acute or chronic pancreatitis, whereas tumorous fistulization or complications of pancreatic surgery were kept out. A total of 113 patients were identified. There were 86 men and 27 women. The mean age was 46.5 years and 78 patients had a history of alcoholism. The mortality rate was 1.8 per cent (two of 113). Non-operative management including interventional therapy and endoscopic stenting was successful in only 40 cases (36%), whereas 73 patients (64%) finally underwent surgery. The most common procedure was distal pancreatectomy (32 of 73). Pleural empyema occurred in 17 cases. Successful nonoperative management had a mean length of 5.5 weeks, whereas surgery was performed after an average of 10.9 weeks of failed conservative efforts. Initial nonoperative therapy was significantly longer in patients eventually sustaining empyema (17 weeks, P < 0.001) and all needed surgical intervention. Prolonged nonoperative treatment is associated with a noteworthy risk of septic complications such as pleural empyema. Further improvement seems achievable by reducing the time gap between fruitless conservative efforts and surgical intervention.

Duplication cyst with midgut volvulus in a neonate: an unusual presentation

2020 ◽  
Vol 13 (8) ◽  
pp. e235526
Author(s):  
Nitin G Pai ◽  
Santosh Prabhu ◽  
Pavithra Prabhakar ◽  
Vijay Kumar
Keyword(s):  
Surgical Intervention ◽  
Case Reports ◽  
Anorectal Malformations ◽  
Duplication Cyst ◽  
Midgut Volvulus ◽  
Rare Association ◽  
Internal Hernias ◽  
Gastrointestinal Duplication Cyst ◽  
Resection And Anastomosis ◽  
Gastrointestinal Duplication

Incomplete intestinal fixation or malrotation of gut with midgut volvulus is one of the important causes of bilious vomiting in neonates. The incidence of malrotation of gut in population is 4% and that of duplication cyst is 1:4500. Patients with malrotation are prone to develop midgut volvulus due to their narrow mesenteric base demanding urgent surgical intervention. Common associated anomalies are intrinsic duodenal obstruction, internal hernias, caecal volvulus, anorectal malformations and Hirschsprung’s disease. The present case refers to a 4-day-old neonate who presented with malrotation of gut with reverse volvulus and an associated gastrointestinal duplication cyst, which is a rare association with only few reported case reports. After imaging with ultrasound and contrast radiograph, the baby underwent prompt surgical intervention in the form of Ladd’s procedure with resection and anastomosis of jejunal duplication cyst.

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