Survival of multiple nail gun injuries to the head, lung, and heart: A case report

2020 ◽  
Author(s):  
Suo-Hsien Wang ◽  
Mao-Yu Chen ◽  
Tzu-Yen Huang ◽  
Che-Chia Chang ◽  
Chih-Ying Chien
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Suicide Attempt ◽  
Surgical Planning ◽  
Surgical Intervention ◽  
Treatment Strategies ◽  
Emergency Physicians ◽  
Significant Morbidity ◽  
Case Presentation ◽  
The Brain

Abstract Background: Most nail gun injuries occur at the extremities due to working accidents. Injuries to the brain or thorax are relatively rare, and cases with both injuries are even rarer. Initial evaluation, resuscitation and surgical planning can be challenging. Case presentation: Here, we present a case with nail gun injuries to the brain, lung, and heart by suicide attempt. The patient presented to the emergency department under shock. After resuscitation and surgical intervention, he was discharged without significant morbidity. Conclusions: Multiple nail gun injuries, especially those to vital organs such as the brain, lung, and heart, can be challenging to emergency physicians and surgeons. Imaging tools, treatment strategies, and possible complications are discussed in this article to provide optimized outcomes in such situations.

scholarly journals Survival after multiple nail gun injuries to the brain, lung, and heart: a case report and a review of the literature

2021 ◽  
Vol 49 (10) ◽  
pp. 030006052110499
Author(s):  
Suo-Hsien Wang ◽  
Mao-Yu Chen ◽  
Jiun-Lin Yan ◽  
Tzu-Yen Huang ◽  
Che-Chia Chang ◽  
...  
Keyword(s):  
Emergency Department ◽  
Surgical Planning ◽  
Cardiac Injury ◽  
Good Prognosis ◽  
Rapid Evaluation ◽  
Emergency Physicians ◽  
Review Of The Literature ◽  
Significant Morbidity ◽  
Work Related ◽  
The Brain

Most nail gun injuries involve the extremities and result from work-related accidents. Injuries to the brain or thorax are relatively rare, and cases with injuries to both regions are even rarer and often lethal. Initial evaluation, resuscitation, and surgical planning can be challenging for emergency physicians and surgeons. We present the details of a man with multiple nail gun injuries to the brain, lung, and heart following a suicide attempt. The patient presented to the emergency department in shock. After immediate resuscitation, emergent sternotomy, and subsequent craniotomy, he was discharged without significant morbidity. According to the literature, this is the only reported case involving multiple nail gun injuries to the brain, lungs, and heart. The mortality rate of multiple nail gun injuries involving the head and chest is approximately 20%. Rapid evaluation, immediate resuscitation, and appropriate imaging and surgery are crucial for increasing survival and achieving a good prognosis. Emergency sternotomy for cardiac injury is the foremost priority, and the timing of craniotomy depends on the patient’s vital sign status and whether brain injury is evident. A preprint of this article is available online: DOI: 10.21203/rs.3.rs-35448/v1.

scholarly journals Catatonia Associated With Late Paraphrenia Successfully Treated With Lithium: A Case Report

2020 ◽  
Author(s):  
Hiroko Sugawara ◽  
Junpei Takamatsu ◽  
Mamoru Hashimoto ◽  
Manabu Ikeda
Keyword(s):  
Case Report ◽  
Mood Disorders ◽  
Electroconvulsive Therapy ◽  
Late Onset ◽  
Treatment Strategies ◽  
Psychotic Symptoms ◽  
Case Presentation ◽  
Limited Efficacy ◽  
Cumulative Evidence ◽  
The Brain

Abstract Background: Catatonia is a psychomotor syndrome that presents various symptoms ranging from stupor to agitation, with prominent disturbances of volition. Its pathogenesis is poorly understood. Benzodiazepines and electroconvulsive therapy (ECT) are safe and effective standard treatments for catatonia; however, alternative treatment strategies have not been established in cases where these treatments are either ineffective or unavailable. Here, we report a case of catatonia associated with late paraphrenia classified as very-late-onset schizophrenia-like psychosis, which was successfully treated with lithium. Case presentation: A 66-year-old single man with hearing impairment developed hallucination and delusions and presented with catatonic stupor after a fall. He initially responded to benzodiazepine therapy; however, his psychotic symptoms became clinically evident and benzodiazepine provided limited efficacy. Blonanserin was ineffective, and ECT was unavailable. His catatonic and psychotic symptoms were finally relieved by lithium monotherapy.Conclusions: Catatonic symptoms are common in patients with mood disorders, suggesting that lithium may be effective in these cases. Moreover, lithium may be effective for both catatonic and psychotic symptoms, as it normalizes imbalances of excitatory and inhibitory systems in the brain, which underlies major psychosis. Cumulative evidence from further cases is needed to validate our findings.

scholarly journals Catatonia associated with late-life psychosis successfully treated with lithium: a case report

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Hiroko Sugawara ◽  
Junpei Takamatsu ◽  
Mamoru Hashimoto ◽  
Manabu Ikeda
Keyword(s):  
Case Report ◽  
Mood Disorders ◽  
Electroconvulsive Therapy ◽  
Treatment Strategies ◽  
Late Life ◽  
Psychotic Symptoms ◽  
Case Presentation ◽  
Limited Efficacy ◽  
Cumulative Evidence ◽  
The Brain

Abstract Background Catatonia is a psychomotor syndrome that presents various symptoms ranging from stupor to agitation, with prominent disturbances of volition. Its pathogenesis is poorly understood. Benzodiazepines and electroconvulsive therapy (ECT) are safe and effective standard treatments for catatonia; however, alternative treatment strategies have not been established in cases where these treatments are either ineffective or unavailable. Here, we report a case of catatonia associated with late-life psychosis, which was successfully treated with lithium. Case presentation A 66-year-old single man with hearing impairment developed hallucination and delusions and presented with catatonic stupor after a fall. He initially responded to benzodiazepine therapy; however, his psychotic symptoms became clinically evident and benzodiazepine provided limited efficacy. Blonanserin was ineffective, and ECT was unavailable. His catatonic and psychotic symptoms were finally relieved by lithium monotherapy. Conclusions Catatonic symptoms are common in patients with mood disorders, suggesting that lithium may be effective in these cases. Moreover, lithium may be effective for both catatonic and psychotic symptoms, as it normalizes imbalances of excitatory and inhibitory systems in the brain, which underlies major psychosis. Cumulative evidence from further cases is needed to validate our findings.

scholarly journals Rectal Foreign Body Removal in the Emergency Department: A Case Report

2020 ◽  
Vol 4 (3) ◽  
pp. 450-453
Author(s):  
Samuel Nesemann ◽  
Kimberly Hubbard ◽  
Mehdi Siddiqui ◽  
William Fernandez
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Foreign Body ◽  
Foreign Bodies ◽  
Surgical Intervention ◽  
Clinical Suspicion ◽  
Emergency Physicians ◽  
Review Of The Literature ◽  
Foreign Body Removal ◽  
Rectal Foreign Bodies

Introduction: Rectal foreign bodies (RFB) pose a challenge to emergency physicians. Patients are not often forthcoming, which can lead to delays to intervention. Thus, RFBs require a heightened clinical suspicion. In the emergency department (ED), extraction may require creative methods to prevent need for surgical intervention. Case Report: The authors present a case of a successful extraction of a RFB in the ED and review of the literature. Conclusion: Retained RFBs are an unusually problematic reason for an ED visit. Thus, it is important for emergency physicians to be comfortable managing such cases appropriately.

scholarly journals First reported case of penile prosthesis infection from brucellosis: case report

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Nabil Nabil Moohialdin ◽  
Ahmad Shamsodini ◽  
Steven K. Wilson ◽  
Osama Abdeljaleel ◽  
Ibrahim Alnadhari ◽  
...  
Keyword(s):  
Case Report ◽  
Broad Spectrum ◽  
Surgical Intervention ◽  
Penile Prosthesis ◽  
Raw Milk ◽  
Prosthesis Infection ◽  
Case Presentation ◽  
First Case ◽  
Milk Ingestion

Abstract Background Infection after the penile prosthesis can be devastating to both the patient and surgeon with various complications and consequences. After introduction of antibiotic-coated implants, the rate of infection has dramatically decreased, but still we see uncommon organisms causing infection. We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. To our knowledge, this is the first reported case of brucellosis penile prosthesis infection. Case presentation We present a first case report of penile prosthesis infection by brucellosis due to raw milk ingestion. A 75-year-old, diabetic male patient presented with penile prosthesis infection 5 months post-penile exchange surgery due to mechanical malfunctioning of 2-piece penile prosthesis which was inserted 11 years ago. The initial treatment with broad spectrum antibiotics did not subside the infection. After diagnosis of brucellosis, the antibiotic was changed to anti-brucellosis (Rifampicin + Tetracycline). The patient improved dramatically and was discharged home with smooth follow-up course. Conclusion Brucellosis can cause infection of penile prosthesis and can be treated with anti-brucellosis antibiotics without necessitating surgical intervention and removal of prosthesis.

scholarly journals Rectosigmoid prolapse - a case report

2015 ◽  
Vol 72 (12) ◽  
pp. 1118-1121
Author(s):  
Vasilije Jeremic ◽  
Srdjan Mijatovic ◽  
Slobodan Krstic ◽  
Sanja Dragasevic ◽  
Tamara Alempijevic
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Sigmoid Colon ◽  
Severe Pain ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Preoperative Management ◽  
Perianal Region ◽  
Rectosigmoid Colon ◽  
Possible Cause

Introduction. Many factors have been indentified as a possible cause of rectal prolaps. Despite the fact that it is not a lifethreating condition, its clinical presentation varies, and sometimes it can present as an emergency. We presented a patient with prolapse of an unusually large segment of the rectosigmoid colon caused by chronic constipation, as an incarcerated segment repaired surgically. Case report. A 62-year-old female patient was referred to the Emergency Department in bad condition with severe pain in the perianal region. On examination a complete rectal prolaps as well as a part of sigmoid colon were found. Macroscopically, the prolapsed segment appeared edematous, livid, with ulcerations. An attempt to manually reduce prolapse failed, therefore resection of 50 cm of sigmoid colon with rectopexy had to be performed. No complications occurred and the patient was without symptoms six months later. Colonoscopy did not reveal any abnormality. Conclusion. Although the preoperative management and preparation of the patient was limited, emergancy surgical intervention for such a case was the strategy of choice due to magnitude of the prolapsing segment. It provided a successful and permenant solution.

scholarly journals Minimal Invasive Surgical Management of Familial Arteriovenous Malformation

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Mokhtar Mamdouh Abdel-Latif ◽  
Shankargouda Patil
Keyword(s):  
Case Report ◽  
Arteriovenous Malformation ◽  
Surgical Management ◽  
Arteriovenous Malformations ◽  
Minimal Invasive ◽  
Favorable Outcome ◽  
Significant Morbidity ◽  
Present Case Report ◽  
Case Presentation ◽  
Oral Region

Introduction. Familial arteriovenous malformations are exceedingly rare. They are often noted at birth. They can also present during childhood or adolescence. Sclerotherapy has proven to have a favorable outcome. Case Presentation. The present case report describes the treatment of arteriovenous malformations on the tongue, labial mucosa, and vermilion border in siblings treated with boiling saline injections. Conclusion. Sclerotherapy using boiling saline had shown to effectively treat arteriovenous malformations in the oral region without any significant morbidity.

scholarly journals A prickly situation: an attempted Caterpillar ingestion - case report

2020 ◽  
Vol 49 (1) ◽  
Author(s):  
Amar K. Bhardwaj ◽  
Naif Fnais ◽  
Christopher J. Chin
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Foreign Body ◽  
Oral Cavity ◽  
Direct Laryngoscopy ◽  
Effective Technique ◽  
Efficient Manner ◽  
Case Presentation ◽  
Tussock Moth ◽  
Initial Method

Abstract Background Foreign body ingestion is a common problem in pediatrics. Each foreign body can present its’ own unique challenges during removal, and we present the management of an ingested Spotted Tussock Moth (Lophocampa maculata), more commonly known as a caterpillar. Case presentation An 18-month-old boy presented to the emergency department with difficulty handling secretions and odynophagia. It was reported he had placed a caterpillar in his mouth and then spat it out. On examination, hundreds of miniscule filaments (setae) were seen embedded in his lips and tongue. Our service was consulted out of concern for airway involvement. The patient was taken to the operating room where a direct laryngoscopy under general anesthesia with spontaneous ventilation was performed to confirm the setae were confined to the anterior tongue and lips. Once we were satisfied the airway was stable, the airway was secured, and we then began to remove the setae. The initial method used was to use Adson-Brown forceps to remove the setae, however this proved difficult and time-consuming given the volume of setae and how thin the setae were. Ultimately, a more effective technique was developed: a 4 × 4 AMD-RITMES® gauze was applied to the mucosa in order to dry up any secretions and then a piece of pink, waterproof BSN medical® tape was applied to the mucosa. After 3 s of contact it was removed. This technique was then repeated and was used to remove the vast majority of the setae. Conclusion To our knowledge, we have described the first technique to remove the caterpillar setae from the oral cavity mucosa in a fast, safe and efficient manner.

scholarly journals Penetrating brain injury with a metal bar and a knife: Report of two interesting cases

2017 ◽  
Vol 31 (2) ◽  
pp. 203-206 ◽  
Author(s):  
Alireza Tabibkhooei ◽  
Morteza Taheri ◽  
Sadra Rohani ◽  
Iran Chanideh ◽  
Hessam Rahatlou
Keyword(s):  
Brain Injury ◽  
Surgical Intervention ◽  
Wide Spectrum ◽  
Good Health ◽  
Brain Parenchyma ◽  
Antibiotic Administration ◽  
Case Presentation ◽  
Penetrating Brain Injury ◽  
Magnetic Resonance Imaging Mri ◽  
The Brain

Introduction Penetrating brain injury (PBI) is uncommon among the civilian population. Here, we report two interesting cases of PBI. Case presentation The first patient was a 20-year-old male who sustained a penetrating head injury with a metal bar during an accident at work. The patient underwent early surgical intervention, and related meningitis was treated with antibiotics. The patient was discharged 45 days later with no deficit. The second patient was a 34-year-old male who was the victim of a violence attack and was admitted to hospital. He was struck by a knife to his right temporal bone. A brain computed tomography scan and magnetic resonance imaging (MRI) demonstrated the tract of the knife within the brain parenchyma. The patient underwent conservative treatment. After several weeks, the patient was discharged in good health. Conclusion Although severe PBI has a poorer prognosis than a blunt brain injury, in treating of these patients, aggressive and timely surgical intervention, proper wide-spectrum antibiotic administration, stringent and diligent care in the intensive-care unit and careful management of the associated complications are mandated.

scholarly journals Case Report: Organic Hallucinosis in Viral Encephalitis

2021 ◽  
Vol 2 (1) ◽  
pp. 61-64
Author(s):  
Andrian Fajar Kusumadewi
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Mental Disorders ◽  
Viral Encephalitis ◽  
Case Presentation ◽  
The Family ◽  
Organic Mental Disorders ◽  
History Of ◽  
The Brain

Introduction : Organic mental disorders are diseases we need to put more attentionon because they are related to systemic disorders or disorders of the brain and cancause high mortality. Organic mental disorders often manifest in the form ofpsychiatric symptoms so that they can be treated too late because the physician isnot able to recognize the symptoms which can be fatal. Sequelae can be found inorganic mental disorders and may affect the patient’s quality of life, so a fast andproper management is needed to get a better outcome. Case presentation: A caseof organic hallucinosis in viral encephalitis had been reported in a 18 year-old malewith a history of sudden changes in behaviour. The symptoms appeared after thepatient had problems during OSPEK and was threatened by someone. The patientwas the only child in the family and often spoiled by his parents. Laboratory andimaging studies showed that there was a cerebritis in the CT scan result, a decreasein CD4 count, and an increase in anti-Rubella IgG titers in which the patient wasfinally diagnosed with viral encephalitis. Conclusion: The diagnosis of organicmental disorders can easily be overlooked in daily clinical practice so that patientsdo not receive proper management

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