scholarly journals Traumatic Diaphragmatic Rupture in An Elderly Patient With Polytrauma

2021 ◽  
Author(s):  
Son Thanh Le ◽  
Hoe Trong Nguyen ◽  
Thanh Chi Ho ◽  
Nguyen Van Tiep
Keyword(s):  
Lower Lobe ◽  
Transverse Process ◽  
Diaphragmatic Rupture ◽  
Spine Injury ◽  
Ct Scanner ◽  
Case Presentation ◽  
Surgical Interventions ◽  
Traumatic Diaphragmatic Rupture ◽  
Chest X Ray ◽  
Pulmonary Laceration

Abstract Case presentation: We report a case of an 80-year-old woman presented to our hospital 2 hours after a traffic accident with multiple injuries: blunt chest injury, rib fractures, pulmonary laceration, right pneumothorax, pleural effusion, right lower lobe atelectasis, right diaphragmatic rupture causing intrathoracic intestinal herniation, blunt abdominal trauma, grade III liver rupture, spine injury with L1, L2 transverse process fractures. An emergency surgery was performed to drain the fluid and air in the pleural cavity, evacuate the hernia organs, and repair the diaphragmatic injury. The postoperative source was uneventful and she was discharged after 20 days. Conclusion Early diagnosis of diaphragmatic rupture in polytrauma requires the combination of clinical examination, chest X-ray, and CT scanner. Favorable outcomes can be achieved with early surgical interventions.

scholarly journals The Role of CT Scan in Recognizing Blunt Diaphragmatic Rupture

2012 ◽  
Vol 1 (1) ◽  
pp. 24-26
Author(s):  
Edward Passos ◽  
Bartolomeu Nascimento ◽  
Fernando Spencer Netto ◽  
Homer Tien
Keyword(s):  
Ct Scan ◽  
Blunt Trauma ◽  
New Technologies ◽  
Motor Vehicle ◽  
Diaphragmatic Rupture ◽  
High Morbidity ◽  
Trauma Patients ◽  
Ct Scanner ◽  
Traumatic Diaphragmatic Rupture

ABSTRACT Background Blunt traumatic diaphragmatic rupture (BTDR) occurs when signicant deceleration mechanism and energy are applied to the torso, and it is associated with signicant injuries and high morbidity and mortality. Although it has limitations, CT scan is the diagnostic of choice for BTDR. This study is a retrospective analyse of our experience in diagnosing BTDR using the 64-slice CT scanner. Sensitivity and specicity of this exam were assessed. Methods We reviewed reports from 2006 to 2009 of all CT scans of the abdomen that were done in the rst 24 hours of hospitalization of blunt trauma patients. We compared CT ndings to surgery reports. Results Our cohort consisted of 2670 patients; 69% were male. We found 28 cases of BTDR, most of them on the patient s left side (54%). Eleven percent of cases were bilateral. BTDR was often caused by motor vehicle collisions. We found sensitivity of 86%, specicity of 99%. Conclusion CT scan is reliable tool in blunt trauma patients. As new technologies arise, its sensibility and specicity also increases. How to cite this article Passos E, Nascimento B, Netto FS, Tien H, Rizoli S. The Role of CT Scan in Recognizing Blunt Diaphragmatic Rupture. Panam J Trauma Critical Care Emerg Surg 2012;1(1):24-26.

scholarly journals Beyond E-FAST scan in trauma: Diagnosing of traumatic diaphragmatic rupture with bedside ultrasound

2017 ◽  
Vol 25 (3) ◽  
pp. 163-165 ◽  
Author(s):  
Jollis Tjhia ◽  
Julina Md Noor
Keyword(s):  
Physical Examination ◽  
Diaphragmatic Rupture ◽  
Bedside Ultrasound ◽  
Ultrasound Scan ◽  
X Ray ◽  
Traumatic Diaphragmatic Rupture ◽  
Chest X Ray ◽  
Basic Investigation

Traumatic diaphragmatic rupture is relatively rare, and even more difficult to diagnose. Physical examination often fails to identify this injury, and basic investigation like chest x-ray can miss this half of the time. Although not part of standard FAST (focused assessment with sonography for trauma) ultrasound scan in trauma, bedside ultrasound has the potential to pick up this pathology. This case illustrates that ultrasound in trauma can go beyond standard E-FAST (extended FAST) protocol.

scholarly journals Effective erector spinae plane block for postoperative analgesia in a pyothorax patient who underwent emergency re-open thoracotomy—a case report

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Izumi Kawagoe ◽  
Daizoh Satoh ◽  
Mariko Fukui ◽  
Kenji Suzuki ◽  
Eiichi Inada
Keyword(s):  
Postoperative Analgesia ◽  
Transverse Process ◽  
Erector Spinae ◽  
Open Thoracotomy ◽  
Case Presentation ◽  
Lung Lobectomy ◽  
Erector Spinae Plane Block ◽  
Lower Lung ◽  
The Right ◽  
Vein Stenosis

Abstract Background The appropriate choice of postoperative analgesia for pyothorax surgery is unclear since local infection could contaminate the catheter used for regional blocks and bacteremia can lead to disordered coagulation. We performed erector spinae plane block (ESPB) in a pyothorax patient undergoing emergency re-open thoracotomy. Case presentation An 81-year-old male with internal jugular vein stenosis on aspirin therapy was scheduled for pyothorax drainage and residual middle lobectomy 14 days after he underwent open right lower lung lobectomy for lung cancer. ESPB was performed with injection of 20 ml of 0.375% levobupivacaine at the Th5 transverse process of the right side under ultrasound guidance. Although he needed intravenous pentazocine for pain on postoperative day 0, no more analgesics were required postoperatively. NRS score ranged from 0 to 1 thereafter. Conclusions ESPB provided effective postoperative analgesia following emergency re-open thoracotomy for our pyothorax patient. ESPB might be the appropriate choice for postoperative analgesia following pyothorax surgery.

scholarly journals A case of pleuroperitoneal communication in which establishing a laparoscopic pneumoperitoneum was useful for the detection of a fistula

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takehiko Manabe ◽  
Kenji Ono ◽  
Soichi Oka ◽  
Yuichiro Kawamura ◽  
Toshihiro Osaki
Keyword(s):  
Thoracic Surgery ◽  
Surgical Repair ◽  
Abdominal Cavity ◽  
Case Presentation ◽  
X Ray ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Pleuroperitoneal Communication ◽  
Small Pore ◽  
Chest X Ray

Abstract Background Pleuroperitoneal communication (PPC) is rarely observed, accounting for 1.6% of all patients who undergo continuous ambulatory peritoneal dialysis (CAPD). Although there have been several reports concerning the management of this condition, we have encountered several cases in which control failed. We herein report a valuable case of PPC in which laparoscopic pneumoperitoneum with video-assisted thoracic surgery (VATS) was useful for supporting the diagnosis and treatment. Case presentation The patient was a 58-year-old woman with chronic renal failure due to chronic renal inflammation who was referred to a nephrologist in our hospital to undergo an operation for the induction of CAPD. Post-operatively, she had respiratory failure, and chest X-ray and computed tomography (CT) showed right-sided hydrothorax that decreased when the injection of peritoneal dialysate was interrupted. Therefore, PPC was suspected, and she was referred to our department for surgical repair. We planned surgical treatment via video-assisted thoracic surgery. During the surgery, we failed to detect any lesions with thoracoscopy alone; we therefore added a laparoscopic port at her right-sided abdomen near the navel and infused CO2 gas into the abdominal cavity. On thoracoscopy, bubbles were observed emanating from a small pore at the central tendon of the diaphragm, which was considered to be the lesion responsible for the PPC. We closed it by suturing directly. Conclusions VATS with laparoscopic pneumoperitoneum should be considered as an effective method for inspecting tiny pores of the diaphragm, especially when the lesions responsible for PPC are difficult to detect.

scholarly journals Inappropriate surgery in a patient with misdiagnosed Robert’s uterus

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Iori Kisu ◽  
Kanako Nakamura ◽  
Tetsuro Shiraishi ◽  
Tomoko Iijima ◽  
Moito Iijima ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Uterine Wall ◽  
Septate Uterus ◽  
Case Presentation ◽  
Surgical Interventions ◽  
Unicornuate Uterus ◽  
Uterine Malformation ◽  
Mullerian Anomaly ◽  
Future Pregnancy

Abstract Background Robert’s uterus is a rare Mullerian anomaly, which can be described as an asymmetric, septate uterus with a non-communicating hemicavity. Herein, we present the case of a misdiagnosed Robert’s uterus, resulting in an invasive and disadvantageous surgery. Case presentation A 16-year-old woman was referred to our department because of dysmenorrhea and suspicion of uterine malformation. We misdiagnosed Robert’s uterus as a unicornuate uterus with a non-communicating rudimentary horn and hematometra, and performed laparoscopic hemi-hysterectomy. Although the patient’s symptoms were relieved, our surgical procedure left the lateral uterine wall weak, making the patient’s uterus susceptible to uterine rupture in any future pregnancy. Conclusions Although the early diagnosis of Robert’s uterus is challenging, it is important in order to determine appropriate surgical interventions and management for maintaining the quality of life and ensuring safety in future pregnancies.

scholarly journals Incidental whole-body MRI evidence of COVID-19 in an asymptomatic patient in a high prevalence region

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Valentina Angelini ◽  
Alberta Villanacci ◽  
Angelo Belotti ◽  
Francesca Castagnoli ◽  
Barbara Frittoli ◽  
...  
Keyword(s):  
Asymptomatic Patient ◽  
Whole Body ◽  
Diagnostic Tools ◽  
Historical Period ◽  
Case Presentation ◽  
Whole Body Mri ◽  
High Prevalence ◽  
Chest X Ray ◽  
Full Knowledge ◽  
Polymerase Chain

Abstract Background The purpose of this case report is to emphasize the importance of curing any clinical radiological elements in this historical period, especially in the area of endemic to coronavirus disease 19 (COVID-19) such as Lombardy and to stress the importance of the management of the asymptomatic patient, their crucial role in the spread of contagion. Case presentation We reported the case of incidental diagnosis of interstitial pneumonia by first finding on whole-body MR (WB-MR) in the patient affected by multiple myeloma (MM), with a negative respiratory symptoms at the time and with previous (1 month before) negative chest X-ray. The patient was promptly subjected to chest CT, which confirmed the suspicion of interstitial COVID-19 pneumonia and, in hospitalization, performed nasopharyngeal swabs for real-time polymerase chain reaction (RNA-PCR), with a doubtful outcome. Once the bacterial nature of the alterations was serologically and radiologically excluded, the patient was definitively diagnosed with COVID-19 and appropriately treated in hospitalization. Conclusion The clinical choices must, therefore, to make use of all the diagnostic tools available and full knowledge of the limitation of each of them.

scholarly journals Isolated Right-Sided Posttraumatic Diaphragmatic Hernia

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Ibrahim Amadou Magagi ◽  
Oumarou Habou ◽  
Harissou Adamou ◽  
Ousseini Adakal ◽  
Mahamoud Omid Ali Ada ◽  
...  
Keyword(s):  
Diaphragmatic Rupture ◽  
Pleural Drainage ◽  
Surgical Department ◽  
Computed Tomographic ◽  
Traumatic Diaphragmatic Rupture ◽  
Abdominal Content ◽  
Pedestrian Accident ◽  
Computed Tomographic Scan ◽  
Diagnostic Difficulties ◽  
Thoracic And Abdominal

Diaphragm is a compliant musculoaponeurotic barrier located between thoracic and abdominal cavities. Traumatic diaphragmatic rupture is a rare clinicopathological entity. We report a case of right-sided posttraumatic hernia in a child following blunt trauma to highlight diagnostic difficulties and therapeutic specific aspects. A 10-year-old boy was admitted to the emergency surgical department with thoracic trauma following pedestrian accident. At admission a haemothorax was suspected and treated by pleural drainage. The diagnosis of a right-sided diaphragmatic rupture was made after computed tomographic scan forty-eight hours later. At surgery, a reduction of herniated abdominal content and a suture of diaphragmatic defect were performed. The postoperative recoveries were uneventful and the patient was followed up for 12 months without symptoms. The possibility of a diaphragmatic rupture should be kept in mind and sought after any trauma of the thoracoabdominal junction as the diagnosis can be challenging in emergency department.

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