scholarly journals Rectal foreign body insertion as a rare cause of persistent lumbosacral plexus injury

2017 ◽  
Vol 99 (6) ◽  
pp. e191-e192 ◽  
Author(s):  
FA Meister ◽  
I Amygdalos ◽  
UP Neumann ◽  
G Lurje
Keyword(s):  
Foreign Body ◽  
Urinary Retention ◽  
Traffic Accidents ◽  
Rectal Wall ◽  
Heavy Traffic ◽  
Loop Ileostomy ◽  
Rectal Mucosa ◽  
Neurological Deficits ◽  
Lumbosacral Plexus ◽  
Post Traumatic

Rectal foreign body insertion is a common condition in emergency surgery, which often requires surgical intervention. Here we report a clinical case of rectal foreign body insertion as a rare cause of persistent lumbosacral plexus injury. A 72-year-old man presented to the emergency department complaining of acute bilateral paraplegia with loss of sensation in both legs, as well as total urinary retention. The patient underwent abdominal computed tomography, which showed a rectal foreign body measuring 13 × 11.5 × 10 cm in the lower abdomen and pelvis. Extraluminal assistance through a median laparotomy was required after unsuccessful attempts at transanal recovery alone. After removal of the foreign body, the rectal wall and anorectal sphincter were massively dilated, with severe bruising of the rectal mucosa on proctoscopy. A protective loop-ileostomy was performed. The sacral plexus is located posteriorly in the pelvis. Physiologically, the nerves are well protected by surrounding anatomical structures. Post-traumatic lumbosacral plexus injuries with paraplegia, urinary retention and anorectal sphincter insufficiency occur quite frequently after heavy traffic accidents. Lumbosacral plexus injury as a result of rectal foreign body insertion is rare. Severe neurological deficits through rectal foreign body insertion are rare but known medical conditions. To the best of our knowledge, this is the first reported case of severe and persistent post-traumatic lumbosacral plexus injury through a rectal foreign body.

scholarly journals Decompressive craniotomy: prognostic factors and complications in 89 patients

2008 ◽  
Vol 66 (2b) ◽  
pp. 369-373 ◽  
Author(s):  
Rodrigo Moreira Faleiro ◽  
Luiz Carlos Mendes Faleiro ◽  
Elisa Caetano ◽  
Isabella Gomide ◽  
Cristina Pita ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Head Injury ◽  
Severe Head Injury ◽  
Traffic Accidents ◽  
Acute Subdural Hematoma ◽  
Brain Swelling ◽  
Decompressive Craniotomy ◽  
Independent Test ◽  
Post Traumatic ◽  
Subdural Effusions

Decompressive craniotomy (DC) is applied to treat post-traumatic intracranial hypertension (ICH). The purpose of this study is to identify prognostic factors and complications of unilateral DC. Eighty-nine patients submited to unilateral DC were retrospectively analyzed over a period of 30 months. Qui square independent test and Fisher test were used to identify prognostic factors. The majority of patients were male (87%). Traffic accidents had occurred in 47% of the cases. 64% of the patients had suffered severe head injury, while pupillary abnormalities were already present in 34%. Brain swelling plus acute subdural hematoma were the most common tomographic findings (64%). Complications occurred in 34.8% of the patients: subdural effusions in 10 (11.2%), hydrocephalus in 7 (7.9%) and infection in 14 (15.7%). The admittance Glasgow coma scale was a statistically significant predictor of outcome ( p=0.0309).

scholarly journals Targeted deletions of complement lectin pathway genes improve outcome in traumatic brain injury, with MASP-2 playing a major role

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
D. Mercurio ◽  
M. Oggioni ◽  
S. Fumagalli ◽  
N. J. Lynch ◽  
S. Roscher ◽  
...  
Keyword(s):  
Functional Activity ◽  
Brain Inflammation ◽  
Neurological Deficits ◽  
Lectin Pathway ◽  
Histopathological Analysis ◽  
Gene Deletions ◽  
Degree Of Protection ◽  
Pharmacological Targets ◽  
Key Enzyme ◽  
Post Traumatic

Abstract The lectin pathway (LP) of complement activation is believed to contribute to brain inflammation. The study aims to identify the key components of the LP contributing to TBI outcome as possible novel pharmacological targets. We compared the long-term neurological deficits and neuropathology of wild-type mice (WT) to that of mice carrying gene deletions of key LP components after experimental TBI. WT or MASP-2 (Masp2−/−), ficolin-A (Fcna−/−), CL-11 (Colec11−/−), MASP-1/3 (Masp1−/−), MBL-C (Mbl2−/−), MBL-A (Mbl1−/−) or MBL−/− (Mbl1−/−/Mbl2−/−) deficient male C57BL/6J mice were used. Mice underwent sham surgery or TBI by controlled cortical impact. The sensorimotor response was evaluated by neuroscore and beam walk tests weekly for 4 weeks. To obtain a comparative analysis of the functional outcome each transgenic line was rated according to a health score calculated on sensorimotor performance. For selected genotypes, brains were harvested 6 weeks after injury for histopathological analysis. MASP-2−/−, MBL−/− and FCN-A−/− mice had better outcome scores compared to WT. Of these, MASP-2−/− mice had the best recovery after TBI, showing reduced sensorimotor deficits (by 33% at 3 weeks and by 36% at 4 weeks). They also showed higher neuronal density in the lesioned cortex with a 31.5% increase compared to WT. Measurement of LP functional activity in plasma from MASP-2−/− mice revealed the absence of LP functional activity using a C4b deposition assay. The LP critically contributes to the post-traumatic inflammatory pathology following TBI with the highest degree of protection achieved through the absence of the LP key enzyme MASP-2, underlining a therapeutic utility of MASP-2 targeting in TBI.

Glass in the frontal sinus: report of three cases

1997 ◽  
Vol 111 (2) ◽  
pp. 156-158 ◽  
Author(s):  
Metin Önerci ◽  
Oğuz Öǧretmenoǧlu ◽  
Taner Yilmaz
Keyword(s):  
Foreign Body ◽  
Paranasal Sinus ◽  
Frontal Sinus ◽  
Traffic Accidents ◽  
Road Traffic ◽  
English Literature ◽  
Maxillofacial Trauma ◽  
Road Traffic Accidents ◽  
Diagnostic Pitfalls

AbstractPatients with paranasal sinus foreign body are not commonly seen in otolaryngological practice; glass in the frontal sinus as a complication of maxillofacial trauma should be very rare, and papers dealing with this issue appear to be rare in the English literature. To elucidate the diagnostic pitfalls and the treatment aspects we present three cases of glass in the frontal sinus which occurred as a result of road traffic accidents.

Gastrointestinal stromal tumor arising in the rectovaginal septum

2004 ◽  
Vol 14 (2) ◽  
pp. 373-377 ◽  
Author(s):  
K. Nasu ◽  
T. Ueda ◽  
S. Kai ◽  
H. Anai ◽  
Y. Kimura ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Submucosal Tumor ◽  
Rectal Wall ◽  
Rectal Mucosa ◽  
Pelvic Lymphadenectomy ◽  
Japanese Woman ◽  
Stromal Tumor ◽  
Resected Specimen ◽  
Rectovaginal Septum ◽  
Tissue Mass

We report herein a rare case of malignant gastrointestinal stromal tumor (GIST) originated from the rectal wall, which presented as a tumor on the rectovaginal septum.A 54-year-old Japanese woman, gravida 4, para 3, was admitted complaining of anuresis and severe constipation. She had a history of hysterectomy and right salpingo-oophorectomy for uterine leiomyoma 11 years previously. Pelvic examination revealed an 8.5 × 7.5 × 7.5 cm hard mass in the rectovaginal space. The inferior border of the tumor was 2 cm from the vaginal introitus and 2 cm from the anus. Computed tomography and magnetic resonance imaging showed a well-circumscribed soft-tissue mass filling the rectovaginal space. Urinary bladder and rectum were markedly compressed and displaced. Colon fiberscopy revealed invasion of the tumor into the rectal mucosa. An abdominoperineal resection of the rectum with posterior vaginal wall resection and pelvic lymphadenectomy was performed. The resected specimen showed a rectal submucosal tumor that was 8 × 8 × 7 cm in size. The tumor was diagnosed as a malignant GIST. Immunohistochemical analysis confirmed this diagnosis. The patient is now healthy without evidence of recurrence at 13 months after surgery.Gynecologists should be aware of rectal GIST arising in the rectovaginal space as a differential diagnosis of vaginal submucosal tumor.

scholarly journals Use of Scheimpflug imaging in the management of intra-lenticular foreign body

2015 ◽  
Vol 7 (1) ◽  
pp. 82-84 ◽  
Author(s):  
R Singh ◽  
J Ram ◽  
R Gupta
Keyword(s):  
Foreign Body ◽  
Intraocular Lens ◽  
Foreign Bodies ◽  
Case Reports ◽  
Slit Lamp ◽  
Traumatic Cataract ◽  
X Ray ◽  
Scheimpflug Imaging ◽  
History Of ◽  
Post Traumatic

Introduction: Asymptomatic traumatic intra-lenticular foreign body is very uncommon and few case reports have been published.Objective: To report a case of post-traumatic intra-lenticular foreign body and use of Scheimpflug imaging in its management. Case: A 41-year-old male with history of injury to right eye during hammering a chisel 1 year back presented with decreased vision since 6 months. An intra-lenticular foreign body was found on slit lamp bio-microscopy and was confrmed by Scheimpflug imaging. Posterior capsule was intact on Scheimpflug imaging. Thus, Scheimpflug imaging helps in exact localization of the foreign body in the intralenticular space or behind the iris. We ruled out other foreign bodies by x-ray and ultrasonography of the orbit. The foreign body with post-traumatic cataract was removed using phacoemulsification and three piece foldable intraocular lens was implanted in the bag. Conclusion: An intra- lenticular foreign body may remain asymptomatic for months. Scheimpflug imaging can be useful in its localization. It can be removed during phacoemulsification.

Psychological consequences of road traffic accidents for children and their mothers

2004 ◽  
Vol 34 (2) ◽  
pp. 335-346 ◽  
Author(s):  
B. BRYANT ◽  
R. MAYOU ◽  
L. WIGGS ◽  
A. EHLERS ◽  
G. STORES
Keyword(s):  
Traffic Accidents ◽  
Stress Disorder ◽  
Acute Stress ◽  
Road Traffic ◽  
Clinical Care ◽  
Self Report ◽  
Road Traffic Accidents ◽  
Post Traumatic Stress ◽  
Psychological Outcome ◽  
Post Traumatic

Background. Little is known about the psychological and behavioural consequences of road traffic accidents for children. The study aimed to determine the outcome of road traffic accidents on children and their mothers.Method. A 1-year cohort study of consecutive child attenders aged 5–16 years at an Accident and Emergency Department. Data were extracted from medical notes and from interview and self-report at baseline, 3 months and 6 months.Results. The children had an excellent physical outcome. Fifteen per cent suffered acute stress disorder; 25% suffered post-traumatic stress disorder at 3 months and 18% at 6 months. Travel anxiety was frequent. Post-traumatic consequences for mothers were common.Conclusion. Psychological outcome was poor for a minority of children and associated with disability, especially for travel. There were significant family consequences. There is a need for changes in clinical care to prevent, identify and treat distressing and disabling problems.

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