scholarly journals Urgent surgical repair is pivotal in the management of major airway injury due to blunt trauma

2020 ◽  
Vol 28 (1) ◽  
Author(s):  
Hysam Abdelmohty ◽  
Mohamed A. Elanwar ◽  
Basem M. Abdelgawad
Keyword(s):  
Blunt Trauma ◽  
Surgical Repair ◽  
Early Recognition ◽  
Diagnostic Tools ◽  
Early Referral ◽  
Systemic Complications ◽  
Airway Injury ◽  
Tracheobronchial Injuries ◽  
Life Threatening ◽  
Repair Group

Abstract Background Blunt traumatic airway injury is a life-threatening injury in which urgent management is pivotal and this would come through improving our clinical management and diagnostic tools. Our objective was to emphasize the importance of early referral and urgent surgical repair of major airway injury. Results Records of 42 patients with major airway injury out of 17,520 registered thoracic trauma cases were reviewed over the past 15 years. Twenty-eight cases documented to have major tracheobronchial injuries due to blunt trauma underwent surgical repair either urgent (21 cases) or late (7 cases). The age ranged from 8 to 43 years old with a mean age of 22.3 ± 0.8. The most common presenting symptom was shortness of breath in 22 (78.6%) cases and the most frequent sign was subcutaneous emphysema which was seen in 22 (78.6%) cases. The postoperative morbidity and mortality rates were significantly higher in the delayed repair group (p value < 0.001). Conclusion The urgent surgical repair is the treatment of choice for major airway injury which is facilitated by early recognition and referral. It is pivotal to avoid respiratory and systemic complications and related mortality.

scholarly journals Heat Stroke: A Medical Emergency Appearing in New Regions

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Sofie Søndergaard Mørch ◽  
Johnny Dohn Holmgren Andersen ◽  
Morten Heiberg Bestle
Keyword(s):  
Heat Waves ◽  
Early Recognition ◽  
Heat Stroke ◽  
Rare Condition ◽  
Medical Emergency ◽  
Temperate Climate ◽  
Morbidly Obese ◽  
Systemic Complications ◽  
Central Nervous System Dysfunction ◽  
Life Threatening

Heat stroke is an acute, life-threatening emergency characterized clinically by elevated body temperature and central nervous system dysfunction. Early recognition and treatment including aggressive cooling and management of life-threatening systemic complications are essential to reduce morbidity and mortality. This case report describes two Danish patients diagnosed with heat stroke syndrome during a heat wave in the summer of 2014. Both patients were morbidly obese and had several predisposing illnesses. However since heat stroke is a rare condition in areas with temperate climate, they were not diagnosed until several days after admittance; hence treatment with cooling was delayed. Both patients were admitted to the intensive care unit, where they were treated with an external cooling device and received treatment for complications. Both cases ended fatally. As global warming continues, more heat waves will occur in previously cooler regions. Therefore it is important to raise awareness of heat stroke since outcome depends on early recognition and rapid cooling.

scholarly journals Repair of traumatic avulsion of the right bronchus in children using extracorporeal membrane oxygenation support

2020 ◽  
Author(s):  
Gabriella Ricciardi ◽  
Léon M Putman ◽  
Mark G Hazekamp
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Blunt Trauma ◽  
Traffic Accidents ◽  
Surgical Repair ◽  
Primary Repair ◽  
Main Bronchus ◽  
Membrane Oxygenation ◽  
Life Threatening ◽  
The Right

Abstract Traumatic avulsion of the right main bronchus in children is usually caused by blunt trauma or traffic accidents. Primary repair by suturing is the preferred treatment. Lesions are life threatening and urgent or emergency surgical repair is indicated. We report our experience with 2 cases of traumatic avulsion of right bronchus in children successfully suture repaired with the use of extracorporeal membrane oxygenation.

scholarly journals Surgical Repair of a Transannular Rupture During Transfemoral Transcatheter Aortic Valve Replacement

2021 ◽  
Vol 14 ◽  
pp. 117954762110381
Author(s):  
Ryaan EL-Andari ◽  
Sabin J Bozso ◽  
Jimmy JH Kang ◽  
Vinod K Manikala ◽  
Michael C Moon ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Surgical Repair ◽  
Hybrid Operating Room ◽  
Transcatheter Aortic Valve ◽  
Acute Decompensation ◽  
Life Threatening ◽  
Midline Sternotomy

Annular rupture is a rare but life-threatening complication of transcatheter aortic valve replacement (TAVR). Mortality rates are high if immediate intervention, most often necessitating surgical repair, is not performed. Herein, we describe an 87-year-old man who, after deployment of TAVR, experienced acute decompensation and required urgent conversion to a midline sternotomy to repair an aortic annular rupture. This case demonstrates an example of a rare but severe complication of TAVR. This report provides an in-depth description of the surgical approach to repair an aortic annular rupture and demonstrates the utility of performing minimally invasive procedures inside a hybrid operating room.

scholarly journals Prevention and management of major complications in percutaneous endoscopic gastrostomy

2021 ◽  
Vol 8 (1) ◽  
pp. e000628
Author(s):  
Kurt Boeykens ◽  
Ivo Duysburgh
Keyword(s):  
Clinical Practice ◽  
Abdominal Wall ◽  
Percutaneous Endoscopic Gastrostomy ◽  
Early Recognition ◽  
Endoscopic Technique ◽  
Abdominal Wound ◽  
Review Of The Literature ◽  
Endoscopic Gastrostomy ◽  
Major Complications ◽  
Life Threatening

BackgroundPercutaneousendoscopic gastrostomy is a commonly used endoscopic technique where a tube isplaced through the abdominal wall mainly to administer fluids, drugs and/orenteral nutrition. Several placement techniques are described in the literaturewith the ‘pull’ technique (Ponsky-Gardener) as the most popular one.Independent of the method used, placement includes a ‘blind’ perforation of thestomach through a small acute surgical abdominal wound. It is a generally safetechnique with only few major complications. Nevertheless these complicationscan be sometimes life-threatening or generate serious morbidity.MethodAnarrative review of the literature of major complications in percutaneousendoscopic gastrostomy.ResultsThis review was written from a clinical viewpoint focussing on prevention andmanagement of major complications and documentedscientific evidence with real cases from more than 20 years of clinical practice.ConclusionsMajorcomplications are rare but prevention, early recognition and popper management areimportant.

Arterial Stiffness Assessed by Cardio-Ankle Vascular Index in Patients With Abdominal Aortic Aneurysm and Its Alterations After Treatment

2021 ◽  
pp. 153857442110232
Author(s):  
Spyridon N. Mylonas ◽  
Konstantinos G. Moulakakis ◽  
Nikolaos Kadoglou ◽  
Constantinos Antonopoulos ◽  
Thomas E. Kotsis ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Surgical Repair ◽  
Open Repair ◽  
Abdominal Aortic ◽  
Gender And Age ◽  
Baseline Values ◽  
The Difference ◽  
The Impact ◽  
Repair Group

Purpose: The aim of the present study was to investigate a potential difference on the arterial stiffness among aneurysm patients and non-aneurysm controls, as well as to explore potential changes between patients treated either with endovascular or open repair. Materials and Methods: A 110 patients with an infrarenal AAA were prospectively enrolled in this study. Fifty-six patients received an EVAR, whereas 54 patients received an open surgical repair. Moreover, 103 gender and age-matched subjects without AAA served as controls. The cardio-ankle vascular index (CAVI) was applied for measurement of the arterial stiffness. Results: CAVI values were statistically higher in the AAA patients when compared with control subjects. Although at 48 hours postoperatively the CAVI values were increased in both groups when compared to baseline values, the difference in CAVI had a tendency to be higher in the open group compared to the endovascular group. At 6 months of follow up the CAVI values returned to the baseline for the patients of the open repair group. However, in the endovascular group CAVI values remained higher when compared with the baseline values. Conclusion: Patients with AAAs demonstrated a higher value of CAVI compared to healthy controls. A significant increase of arterial stiffness in both groups during the immediate postoperative period was documented. The increase in arterial stiffness remained significant at 6 months in EVAR patients. Further studies are needed to elucidate the impact of a decreased aortic compliance after stentgraft implantation on the cardiac function of patients with AAA.

scholarly journals A case of amniotic fluid embolism successfully treated by multidisciplinary treatment

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Yuki Kinishi ◽  
Chiyo Ootaki ◽  
Takeshi Iritakenishi ◽  
Yuji Fujino
Keyword(s):  
Amniotic Fluid ◽  
Early Recognition ◽  
Multidisciplinary Treatment ◽  
Balloon Catheter ◽  
Amniotic Fluid Embolism ◽  
Pathological Examination ◽  
Total Blood ◽  
Occlusion Balloon ◽  
Life Threatening ◽  
Labor Epidural

Abstract Background Amniotic fluid embolism (AFE) is a life-threatening obstetric emergency. Because the maternal mortality associated with AFE is very high, early recognition and prompt treatment are important for improving the prognosis. We report a case of amniotic fluid embolism successfully treated by multidisciplinary treatment. Case presentation A 39-year-old woman with fetal congenital heart anomaly and polyhydramnios was scheduled for induction of delivery at 37 weeks of gestation with labor epidural analgesia. Uncontrollable bleeding occurred 30 min after vaginal delivery. Based on the clinical diagnosis of AFE, massive blood transfusion, insertion of an aortic occlusion balloon catheter, and hysterectomy was performed. Total blood loss was 12,000 mL. The diagnosis of AFE was confirmed by pathological examination. She was discharged with no complications. Conclusion We report a case of AFE who were rescued by prompt diagnosis and treatment.

scholarly journals Tick-Borne-Associated Illnesses in the Pediatric Intensive Care Unit

2020 ◽  
Vol 15 (06) ◽  
pp. 269-275
Author(s):  
Kaila Lessner ◽  
Conrad Krawiec
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Early Recognition ◽  
Spotted Fever ◽  
Pediatric Intensive Care ◽  
Rocky Mountain ◽  
Rocky Mountain Spotted Fever ◽  
Life Threatening ◽  
Human Ehrlichiosis

AbstractWhen unrecognized and antibiotic delay occurs, Lyme disease, Rocky Mountain–spotted fever, babesiosis, and human ehrlichiosis and anaplasmosis can result in multiorgan system dysfunction and potentially death. This review focuses on the early recognition, evaluation, and stabilization of the rare life-threatening sequelae seen in tick-borne illnesses that require admission in the pediatric intensive care unit.

Pyriform sinus rupture caused by blunt trauma

2020 ◽  
pp. 197140092097516
Author(s):  
Emil Jernstedt Barkovich ◽  
M Reza Taheri
Keyword(s):  
Blunt Trauma ◽  
Pyriform Sinus ◽  
Significant Heterogeneity ◽  
Cervical Trauma ◽  
Specific Location ◽  
Appropriate Treatment ◽  
Threatening Condition ◽  
Pharyngeal Perforation ◽  
Life Threatening ◽  
Foreign Body Impaction

Hypopharyngeal perforation (HP) is a potentially life-threatening condition most associated with iatrogenic injury and foreign body impaction. Additionally, a number of cases of posterior HP have been reported following blunt cervical trauma. We present a case of a construction accident causing lateral hypopharyngeal rupture. Visceral perforation was initially diagnosed on computed tomography (CT) imaging and managed conservatively. We speculate this region may be particularly vulnerable to injury due to an anatomic transition in adjacent fascial support. A review of 29 prior cases suggests that this may be the first reported case of blunt trauma causing rupture of the pyriform sinus. However, significant heterogeneity exists in diagnostic approach. Radiography and CT are rapid, sensitive modalities for suggesting pharyngeal perforation, while fluoroscopy and endoscopy can better assess injury size and location and monitor resolution. Early radiologic recognition of hypopharyngeal injury is essential to initiate appropriate treatment. In certain cases, including our own, both the presence and specific location of perforation may be identified on initial CT images.

scholarly journals An unusual cause of recurrent pediatric vomiting (an extraluminal pyloric duplication cystic): A case report

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Leen Jamel Doya ◽  
Naya Talal Hassan ◽  
Fareeda Wasfy Bijow ◽  
Hanin Ahmed Mansour ◽  
Sawsan Ahmad ◽  
...  
Keyword(s):  
Gastrointestinal Endoscopy ◽  
Early Recognition ◽  
Outlet Obstruction ◽  
Abdominal Ultrasound ◽  
Duplication Cyst ◽  
Common Symptom ◽  
Surgical Emergencies ◽  
Recurrent Vomiting ◽  
Life Threatening ◽  
Tomography Scan

ABSTRACT Vomiting is a common symptom of a multitude of diseases in children. It is usually part of benign illness and can occur at any age. Recurrent vomiting can be a symptom of life-threatening medical or surgical emergencies. It can be rarely caused by an extraluminal pyloric duplication cyst. Early recognition is essential for preventing delays in management and potential complications. Here we report a case of an extraluminal pyloric duplication presenting as progressive gastric outlet obstruction cyst in a 14-month-old Syrian boy. The diagnosis was made through abdominal ultrasound, gastrointestinal endoscopy and abdominal computed tomography scan.

Postpartum ovarian vein thrombosis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Kelly Ribeiro ◽  
Samir Mahboobani ◽  
Katherine Van Ree ◽  
Katy Clifford ◽  
TG Teoh
Keyword(s):  
Abdominal Pain ◽  
Complete Resolution ◽  
Early Recognition ◽  
Ovarian Vein ◽  
Transabdominal Ultrasound ◽  
Case Presentation ◽  
Vein Thrombosis ◽  
Prompt Treatment ◽  
Life Threatening ◽  
Ovarian Vein Thrombosis

Abstract Objectives Postpartum ovarian vein thrombosis (POVT) is a rare pathology that can lead to severe complications such as sepsis, extension of the thrombus leading to organ failure, and pulmonary embolism. It therefore requires early recognition and prompt treatment. Case presentation A patient with right POVT presented four days after delivery with acute right-sided abdominal pain and fever. Appendicitis was initially considered, before an abdominal-pelvic computed tomography raised the suspicion of POVT, subsequently confirmed through transabdominal ultrasound. Antibiotics and anticoagulation were initiated, with rapid clinical improvement and complete resolution of the thrombus three months later. Conclusions Diagnosing POVT is challenging as it clinically mimics other more frequent conditions. It is rare but life-threatening and should be considered in all females presenting with abdominal pain and fever in the postpartum period.

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