scholarly journals Orbitakompartment-szindróma. Arcot ért trauma következtében leggyakrabban vakságot okozó állapot

2017 ◽  
Vol 158 (36) ◽  
pp. 1410-1420 ◽  
Author(s):  
Gusztáv Klenk ◽  
József Katona ◽  
Gábor Kenderfi ◽  
János Lestyán ◽  
Katalin Gombos ◽  
...  
Keyword(s):  
Foreign Body ◽  
Compartment Syndrome ◽  
Surgical Intervention ◽  
Rare Condition ◽  
Surgical Decompression ◽  
Facial Fractures ◽  
Common Cause ◽  
Short Period ◽  
Retinal Artery ◽  
Lateral Canthotomy

Abstract: Introduction: Although orbital compartment syndrome is a rare condition, it is still the most common cause of blindness following simple or complicated facial fractures. Its pathomechanism is similar to the compartment syndrome in the limb. Little extra fluid (blood, oedema, brain, foreign body) in a non-space yielding space results with increasingly higher pressures within a short period of time. Unless urgent surgical intervention is performed the blocked circulation of the central retinal artery will result irreversible ophthalmic nerve damage and blindness. Aim, material and method: A retrospective analysis of ten years, 2007–2017, in our hospital among those patients referred to us with facial-head trauma combined with blindness. Results: 571 patients had fractures involving the orbit. 23 patients become blind from different reasons. The most common cause was orbital compartment syndrome in 17 patients; all had retrobulbar haematomas as well. 6 patients with retrobulbar haematoma did not develop compartment syndrome. Compartment syndrome was found among patient with extensive and minimal fractures such as with large and minimal haematomas. Early lateral canthotomy and decompression saved 7 patients from blindness. Conclusion: We can not predict and do not know why some patients develop orbital compartment syndrome. Compartment syndrome seems independent from fracture mechanism, comminution, dislocation, amount of orbital bleeding. All patients are in potential risk with midface fractures. We have a high suspicion that orbital compartment syndrome has been somehow missed out in the recommended textbooks of our medical universities and in the postgraduate trainings. Thus compartment syndrome is not recognized. Teaching, training and early surgical decompression is the only solution to save the blind eye. Orv Hetil. 2017; 158(36): 1410–1420.

scholarly journals Abdominal Compartment Syndrome—When is Surgical Decompression Needed?

Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2294
Author(s):  
Dan Nicolae Păduraru ◽  
Octavian Andronic ◽  
Florentina Mușat ◽  
Alexandra Bolocan ◽  
Mihai Cristian Dumitrașcu ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Aortic Aneurysm ◽  
Compartment Syndrome ◽  
Observational Studies ◽  
Surgical Intervention ◽  
Surgical Decompression ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Severe Burns ◽  
Abdominal Aortic ◽  
Abdominal Compartment

Compartment syndrome occurs when increased pressure inside a closed anatomical space compromises tissue perfusion. The sudden increase in pressure inside these spaces requires rapid decompression by means of surgical intervention. In the case of abdominal compartment syndrome (ACS), surgical decompression consists of a laparostomy. The aim of this review is to identify the landmarks and indications for the appropriate moment to perform decompression laparotomy in patients with ACS based on available published data. A targeted literature review was conducted on indications for decompression laparotomy in ACS. The search was focused on three conditions characterized by a high ACS prevalence, namely acute pancreatitis, ruptured abdominal aortic aneurysm and severe burns. There is still a debate around the clinical characteristics which require surgical intervention in ACS. According to the limited data published from observational studies, laparotomy is usually performed when intra-abdominal pressure reaches values ranging from 25 to 36 mmHg on average in the case of acute pancreatitis. In cases of a ruptured abdominal aortic aneurysm, there is a higher urgency to perform decompression laparotomy for ACS due to the possibility of continuous hemorrhage. The most conflicting recommendations on whether surgical treatment should be delayed in favor of other non-surgical interventions come from studies involving patients with severe burns. The results of the review must be interpreted in the context of the limited available robust data from observational studies and clinical trials.

scholarly journals Traumatic Orbital Compartment Syndrome: A Sight Threatening Emergency

2019 ◽  
Vol 11 (1) ◽  
pp. 91-97
Author(s):  
Kinsuk Singh ◽  
Gulshan Bahadur Shrestha
Keyword(s):  
Emergency Department ◽  
Compartment Syndrome ◽  
Clinical Diagnosis ◽  
Surgical Intervention ◽  
Case Series ◽  
University Teaching ◽  
Orbital Trauma ◽  
Rare Presentation ◽  
Lateral Canthotomy ◽  
Made In

Orbital compartment syndrome is a rare presentation of orbital trauma and is an ophthalmic emergency. Delay in clinical diagnosis and subsequent surgical intervention will lead to loss of vision in nick of time. We presented a case series of orbital compartment syndrome secondary to trauma who presented to the emergency department of Tribhuvan University Teaching Hospital during the devastating earthquake in April 2015. Clinical diagnosis of orbital compartment syndrome was made in the bedside and all the patients underwent emergency lateral canthotomy and inferior cantholysis. This case series was aimed to describe clinical features and management of orbital compartment syndrome.

NECROTISING FASCIITIS CAUSING COMPARTMENT SYNDROME OF THE FOREARM AND SEPTIC SHOCK DUE TO VIBRIO VULNIFICUS: A CASE REPORT

Hand Surgery ◽  
2006 ◽  
Vol 11 (01n02) ◽  
pp. 77-82
Author(s):  
Somsak Leechavengvongs ◽  
Suwanee Jidpugdeebodin ◽  
Samaniya Milindankura
Keyword(s):  
Septic Shock ◽  
Compartment Syndrome ◽  
Surgical Intervention ◽  
Vibrio Vulnificus ◽  
Hand Function ◽  
Surgical Decompression ◽  
Necrotising Fasciitis ◽  
Necrotic Tissue ◽  
Systemic Antibiotic Treatment ◽  
Limited Motion

Compartment syndrome caused by necrotising fasciitis has rarely been described. We report a case of systemic Vibrio vulnificus necrotising fasciitis presented with compartmental syndrome of the forearm and septic shock. The patient was treated with systemic antibiotic treatment and urgent surgical decompression followed by multiple necrotic tissue debridements. The patient recovered with some limited motion of the hand function. Prompt recognition and immediate treatment with antibiotics and surgical intervention are essential.

scholarly journals A case of acute compartment syndrome of the hand complicating subcutaneous emphysema due to accidental nitrogen gas insufflation

2019 ◽  
Vol 27 (1) ◽  
pp. 81-84
Author(s):  
Collin SK Looi ◽  
Manohar Arumugam
Keyword(s):  
Compartment Syndrome ◽  
Current Literature ◽  
Subcutaneous Emphysema ◽  
Surgical Intervention ◽  
Rare Condition ◽  
Acute Compartment Syndrome ◽  
Potential Complication ◽  
Nitrogen Gas ◽  
Unique Case

Non-infectious subcutaneous emphysema of the hand has previously been mentioned in literature. In most cases, it presents in a benign and self-resolving form, which may be managed conservatively. However, in cases of subcutaneous emphysema involving insufflation with nitrogen gas, clinical vigilance is advised as acute compartment syndrome may be a potential complication due to the non-permeative nature of the gas. This would necessitate a complete change in the dynamics of management, warranting urgent surgical intervention. Current literature on acute compartment syndrome of the hand complicating subcutaneous emphysema is scarce. This report aims to highlight this unique case and add to the current literature on this rare condition.

Validation of the Surgical Intervention for Traumatic Injury scale in the pediatric population

2020 ◽  
Vol 26 (1) ◽  
pp. 92-97
Author(s):  
David Dornbos ◽  
Christy Monson ◽  
Andrew Look ◽  
Kristin Huntoon ◽  
Luke G. F. Smith ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Pediatric Population ◽  
Traumatic Injury ◽  
Pediatric Trauma ◽  
Current Method ◽  
Clinical Findings ◽  
Surgical Decompression ◽  
Operative Intervention ◽  
Admission Diagnosis ◽  
Communication Tool

OBJECTIVEWhile the Glasgow Coma Scale (GCS) has been effective in describing severity in traumatic brain injury (TBI), there is no current method for communicating the possible need for surgical intervention. This study utilizes a recently developed scoring system, the Surgical Intervention for Traumatic Injury (SITI) scale, which was developed to efficiently communicate the potential need for surgical decompression in adult patients with TBI. The objective of this study was to apply the SITI scale to a pediatric population to provide a tool to increase communication of possible surgical urgency.METHODSThe SITI scale uses both radiographic and clinical findings, including the GCS score on presentation, pupillary examination, and CT findings. To examine the scale in pediatric TBI, a neurotrauma database at a level 1 pediatric trauma center was retrospectively evaluated, and the SITI score for all patients with an admission diagnosis of TBI between 2010 and 2015 was calculated. The primary endpoint was operative intervention, defined as a craniotomy or craniectomy for decompression, performed within the first 24 hours of admission.RESULTSA total of 1524 patients met inclusion criteria for the study during the 5-year span: 1469 (96.4%) were managed nonoperatively and 55 (3.6%) patients underwent emergent operative intervention. The mean SITI score was 4.98 ± 0.31 for patients undergoing surgical intervention and 0.41 ± 0.02 for patients treated nonoperatively (p < 0.0001). The area under the receiver operating characteristic (AUROC) curve was used to examine the diagnostic accuracy of the SITI scale in this pediatric population and was found to be 0.98. Further evaluation of patients presenting with moderate to severe TBI revealed a mean SITI score of 5.51 ± 0.31 in 40 (15.3%) operative patients and 1.55 ± 0.02 in 221 (84.7%) nonoperative patients, with an AUROC curve of 0.95.CONCLUSIONSThe SITI scale was designed to be a simple, objective communication tool regarding the potential need for surgical decompression after TBI. Application of this scale to a pediatric population reveals that the score correlated with the perceived need for emergent surgical intervention, further suggesting its potential utility in clinical practice.

scholarly journals A Clinicoradiological Assessment following Surgical Intervention in Patients of Cervical Spondylotic Myelopathy: An Institutional Experience

2021 ◽  
Author(s):  
Maneet Gill ◽  
Vikas Maheshwari ◽  
Arun Kumar Yadav ◽  
Rushikesh Gadhavi
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Surgical Intervention ◽  
Japanese Orthopaedic Association ◽  
Surgical Decompression ◽  
Functional Improvement ◽  
Male Predominance ◽  
Canal Diameter ◽  
Posterior Group

Abstract Introduction  To critically analyze the functional and radiological improvement in patients of cervical spondylotic myelopathy (CSM) who underwent surgical decompression by an anterior or posterior approach. Materials and Methods  A retrospective study was conducted in a tertiary-level Armed Forces Hospital from June 2015 to December 2019. Preoperative assessment included a thorough clinical examination and functional and radiological assessment. The surgical decompression was done by an anterior or a posterior approach with instrumented fusion. Anterior approach was taken for single or two-level involvement and posterior approach for three or more cervical levels. The pre and postoperative neurological outcome was assessed by Nurick and modified Japanese Orthopaedic Association (mJOA) score along with measurement of canal diameter and cross-sectional area. Results  A total of 120 patients of CSM who underwent surgical decompression were analyzed. Both the groups were comparable and had male predominance. A total of 59 patients underwent surgical decompression by an anterior approach and the remaining 61 patients by the posterior approach. Out of the 59 patients operated by the anterior approach, 30 (50.85%) underwent anterior cervical discectomy and fusion (ACDF); remaining 29 (49.15%) underwent anterior cervical corpectomy and fusion (ACCF). In the posterior group (n = 61), 26 (42.6%) patients underwent laminoplasty and the remaining 35 (57.4%) underwent laminectomy with or without instrument fusion. Sixteen patients out of these underwent lateral mass fixation and the remaining 19 underwent laminectomy. There was functional improvement (mJOA and Nurick grade) and radiological improvement in both subgroups, which were statistically significant (p < 0.0001). Conclusion  A prompt surgical intervention in moderate-to-severe cases of CSM either by the anterior or the posterior approach is essential for good outcome.

Tracheoinnominate fistula: surgical management of an iatrogenic disaster

2006 ◽  
Vol 120 (8) ◽  
pp. 676-680 ◽  
Author(s):  
R W Ridley ◽  
J B Zwischenberger
Keyword(s):  
Operating Room ◽  
Surgical Management ◽  
Surgical Repair ◽  
Surgical Intervention ◽  
Pectoralis Major Muscle ◽  
Muscle Flap ◽  
Rare Condition ◽  
Innominate Artery ◽  
Significant Potential ◽  
High Index Of Suspicion

Tracheoinnominate fistula (TIF) is a rare condition with significant potential for mortality if surgical intervention is not immediate. We present two cases of successfully managed TIF. Both cases involve ligation and resection of the innominate artery at the TIF followed by a pectoralis major muscle flap. In both cases, success was largely due to a high index of suspicion and immediate control of the bleeding with transport to the operating room for surgical repair. The history, aetiology, and pathogenesis of TIF are reviewed, yielding an algorithm for recommended management of TIF.

scholarly journals Submental method for orotracheal intubation in treating facial trauma

1998 ◽  
Vol 116 (5) ◽  
pp. 1829-1832 ◽  
Author(s):  
Luiz Carlos Manganello-Souza ◽  
Nicolas Tenorio-Cabezas ◽  
Luiz Piccinini Filho
Keyword(s):  
Tracheal Intubation ◽  
General Anesthesia ◽  
Surgical Intervention ◽  
Orotracheal Intubation ◽  
Facial Trauma ◽  
Facial Fractures ◽  
Surgical Team ◽  
Visible Scar ◽  
Alternative Method

OBJECTIVE: To demonstrate an alternative method for intubating patients with fractures of maxilla and nose, prior to surgery. DESIGN: Cases Report. PARTICIPANTS: We studied 10 patients with facial fractures that affected maxilla and nose. INTERVENTION: The patients were submitted to surgery under general anesthesia and submental oro-tracheal intubation. RESULTS: This type of intubation allowed the surgical team to work on the whole face of the patient and left no visible scar. CONCLUSION: This procedure is indicated for patients with fractures of maxilla and nose who need surgical intervention under general anesthesia.

Surgical Off-loading of the Diabetic Foot

2010 ◽  
Vol 100 (5) ◽  
pp. 369-384 ◽  
Author(s):  
Robert G. Frykberg ◽  
Nicholas J. Bevilacqua ◽  
Geoffrey Habershaw
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
Diabetic Foot ◽  
Surgical Intervention ◽  
Surgical Decompression ◽  
Foot Ulcers ◽  
Foot Surgery ◽  
Patients With Diabetes

Surgical intervention for chronic deformities and ulcerations has become an important component in the management of patients with diabetes mellitus. Such patients are no longer relegated to wearing cumbersome braces or footwear for deformities that might otherwise be easily corrected. Although surgical intervention in these often high-risk individuals is not without risk, the outcomes are fairly predictable when patients are properly selected and evaluated. In this brief review, we discuss the rationale and indications for diabetic foot surgery, focusing on the surgical decompression of deformities that frequently lead to foot ulcers. (J Am Podiatr Med Assoc 100(5): 369–384, 2010)

Complete Bilateral Brachial Plexus Injury from Rhabdomyolysis and Compartment Syndrome: Surgical Case Report

2018 ◽  
Vol 17 (2) ◽  
pp. E68-E72 ◽  
Author(s):  
Daniel A Tonetti ◽  
Ivan S Tarkin ◽  
Kiran Bandi ◽  
John J Moossy
Keyword(s):  
Brachial Plexus ◽  
Compartment Syndrome ◽  
Clinical Presentation ◽  
Brachial Plexus Injury ◽  
Laboratory Data ◽  
Surgical Decompression ◽  
Sensory Function ◽  
Resonance Imaging ◽  
Pectoralis Muscles ◽  
Prolonged Immobilization

Abstract BACKGROUND AND IMPORTANCE Acute bilateral brachial plexus injury is rare and usually a result of traction injury. Immediate operative intervention is reserved for rare cases of ongoing compression of the plexus; the role for acute decompression of the brachial plexus secondary to compartment syndrome has not been previously described. In this report, we describe the technique and role for urgent brachial plexus decompression. CLINICAL PRESENTATION A 32-yr-old man presented with acute complete bilateral brachial plexus palsy due to focal rhabdomyolysis and brachial plexus compression after a night of excess alcohol and methadone ingestion. He had complete loss of motor and sensory function from C5 to T1, with the exception of partial sensory sparing of the C5 dermatome. Magnetic resonance imaging demonstrated diffuse muscular edema of the supraclavicular and infraclavicular fossae in addition to the pectoralis muscles and the deltoids bilaterally. He underwent urgent surgical decompression of his supraclavicular and infraclavicular fossae with fasciotomies of the pectoral muscles and the anterior deltoids, allowing direct visualization and decompression of the entire brachial plexus resulting in a near-complete functional recovery. CONCLUSION Neurosurgeons should include brachial plexus compression due to compartment syndrome in the differential diagnosis of patients with acute upper extremity weakness, particularly when associated with prolonged immobilization and/or substance abuse. Prompt surgical decompression should be performed in these patients if imaging and laboratory data suggest compartment syndrome and resultant neurological deficit.

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