scholarly journals Management of Vascular Injury in a Vascular Center of a Developing Country

2021 ◽  
Vol 36 (1) ◽  
pp. 32-37
Author(s):  
Quazi Abul Azad ◽  
Aizizul Islam Khan ◽  
Abdullah Al Mamun ◽  
Nirmal Kanti Dey ◽  
Sajia Sajmin Siddiqua ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
Developing Country ◽  
Vascular Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Young Male ◽  
Developed Countries ◽  
Limb Amputation ◽  
Vascular Injuries ◽  
Associated Injuries

In surgical practice management of vascular injuries are challenging. Vascular injuries are well addressed in developed countries but there is scarcity of vascular surgeons in developing countries like us and a large number of victims fail to reach specialist in time with consequent loss of limbs or lives. To observe the pattern and outcome of management of vascular injury in a developing country this retrospective study was conducted at the department of vascular surgery, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh. All patients with vascular injury arrived alive were included in the study. Date in terms of age, sex, cause of injury, segment of vessel involved, associated injuries, time elapsed after injury, vascular procedures done and postoperative complications were taken from records of the department and were analyzed. Out of 2174 patients with vascular injury 11 patients died at resuscitation & 52 did not come back after referral to other hospitals for management of associated injuries. Most of the patients were young male & road traffic accidents was the most common cause (91.50%). Majority (53.60%) of the patients presented after 6 hours. Majority of the cases lower limb vessels were injured (64.05%). Among the associated injuries combine orthopedic & soft tissue injuries were most common (60.58%). Among the vascular procedures antilogous venous graft (42.39%) followed by end to end anastomosis (27.79%) were in majority of the cases. In case of extremity vascular injury limb amputation rate was 35.40%. This morbidity can be reduced by improvement of road safely measures, encouraging doctors to vascular surgery specialty and effective training of orthopedic & general surgeons in the management of extremity vascular injury till the availability of vascular surgeons for provision of vascular services in remote areas. Bangladesh Heart Journal 2021; 36(1) : 32-37

scholarly journals Vascular injuries during gynecological laparoscopy: the vascular surgeon's advice

2005 ◽  
Vol 123 (1) ◽  
pp. 38-41 ◽  
Author(s):  
Marcello Barbosa Barros ◽  
Francisco S. Lozano ◽  
Luis Queral
Keyword(s):  
Small Bowel ◽  
Vascular Surgery ◽  
Vascular Injury ◽  
Postoperative Period ◽  
Vascular Injuries ◽  
Venous Graft ◽  
Vascular Surgeon ◽  
Gynecological Laparoscopy

CONTEXT: Iatrogenic vascular problems due to laparoscopy are a well recognized problem and lead to significant repercussions. In this context, a ten-year review of cases topic is presented, based on experience gained while heading two important vascular surgery services. CASES: Five patients with vascular injuries during elective laparoscopy are described. These patients presented with seven lesions of iliac vessels. All cases were evaluated immediately and required laparotomy, provisional hemostasis and urgent attendance by a vascular surgeon. Direct suturing was performed in three cases. One aortoiliac bypass and one ilioiliac reversed venous graft were made. Venous lesions were sutured. One case of a point-like perforation of the small bowel was found. There were no deaths and no complications during the postoperative period. DISCUSSION: Important points on this subject are made, and advice is given. There needs to be immediate recognition of the vascular injury, and expert repair by a vascular surgeon is recommended, in order to significantly reduce the degree of complications.

scholarly journals Delayed Presentation Of Missed Vascular Injuries And Pitfalls In Primary Treatment– Experience Of A Vascular Surgery Unit In Pakistan

2018 ◽  
Vol 08 (04) ◽  
pp. 258-262
Author(s):  
Ahsin Manzoor Bhatti ◽  
Junaid Mansoor ◽  
Haroon Sabir Khan
Keyword(s):  
Vascular Surgery ◽  
Vascular Injury ◽  
Tertiary Care ◽  
Primary Treatment ◽  
Vascular Trauma ◽  
Adverse Outcomes ◽  
Delayed Presentation ◽  
Vascular Injuries ◽  
Vascular Repair ◽  
Missed Injuries

Objective: To analyze errors in primary treatment of vascular injuries and delayed presentations of missed vascular injuries as a surrogate indicator of need for improved vascular surgical training of upcoming general surgeons. Materials and methods: This retrospective observational study was carried out at vascular surgery department of two tertiary care hospitals of Armed Forces from Jan 2012 to June 2017. Hospital records of all patients with vascular trauma were analyzed for presence of pitfalls in primary treatment and delayed presentation of missed vascular injuries which resulted in redo surgeries or adverse outcomes. Results: Out of 256 patients with vascular injury sequel 41 had either a problem in primary treatment or presented with delayed complications of missed injuries. The omissions can be divided into: missed injuries (24/41), technical errors in initial repair (12/24), reperfusion of mangled Extremity (3/41) and non availability of a surgeon capable of undertaking vascular repair. The commonest operative fault was failure to debride the vessel adequately and vascular repair under tension. The commonest primary assessment problem was failure to timely appreciate hard signs of vascular injury. Conclusion: With better training and emphasizing the need of thorough clinical examination outcome of vascular trauma can be improved.

scholarly journals Posttraumatic Pneumopericardium: A Sign of Severe Injury or Radiodiagnostic Rarity?

2006 ◽  
Vol 49 (2) ◽  
pp. 129-132 ◽  
Author(s):  
Vladimír Lonský ◽  
Jiří Manďák ◽  
Jan Harrer ◽  
Martin Tuna ◽  
Petr Dvořák ◽  
...  
Keyword(s):  
Transesophageal Echocardiography ◽  
Blunt Chest Trauma ◽  
Traffic Accidents ◽  
Chest Trauma ◽  
Road Traffic ◽  
Severe Injury ◽  
Road Traffic Accidents ◽  
Associated Injuries ◽  
Air Tamponade ◽  
Trauma Injury

We present three cases of pneumopericardium following blunt chest trauma injury. All three patients were victims of road traffic accidents. All had multiple associated injuries and pneumopericardium was found as the additional finding. Pneumopericardium was treated conservatively with thoracic drains placement and patients observation. Transesophageal echocardiography was used as a method of choice for exclusion of cardiac air tamponade. All three patients survived.

Road Traffic Accident Related Morbidity as Seen in an Accident and Emergency Department

1981 ◽  
Vol 26 (2) ◽  
pp. 121-124 ◽  
Author(s):  
D. J. Galloway ◽  
A. R. Patel
Keyword(s):  
Emergency Department ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Young Male ◽  
Education Programme ◽  
Small Sample ◽  
Accident And Emergency ◽  
Number Of Patients ◽  
Accident And Emergency Department ◽  
Serious Injuries

This paper describes some of the findings of a prospective study of victims of road traffic accidents arriving at the Western Infirmary's Accident and Emergency Department over a period of 12 months. More than half the accidents occurred during leisure hours thus likely to stretch the resources of the hospital services. More than a third of the total number of patients were young male drivers. Serious injuries were significantly more often sustained among pedestrians who were often older. Victims of motor-cycle accidents less often escaped serious injuries. Blood ethanol studies on a small sample suggested that male pedestrians were often highly intoxicated. A public health education programme is regarded as a primary measure in preventing a large proportion of serious morbidity and mortality especially amongst pedestrians.

scholarly journals An epidemiological study of traumatic brachial plexus injury patients treated at an Indian centre

2012 ◽  
Vol 45 (03) ◽  
pp. 498-503 ◽  
Author(s):  
Darshan Kumar A. Jain ◽  
Praveen Bhardwaj ◽  
Hari Venkataramani ◽  
S. Raja Sabapathy
Keyword(s):  
Brachial Plexus ◽  
Traffic Accidents ◽  
Brachial Plexus Injury ◽  
Road Traffic ◽  
Time Interval ◽  
Dominant Hand ◽  
Road Traffic Accidents ◽  
Associated Injuries ◽  
Lower Velocity ◽  
Indian Centre

ABSTRACT Background: Epidemiological studies on traumatic brachial plexus injuries are few and these studies help us to improve the treatment, rehabilitation of these patients and to allocate the resources required in their management. Epidemiological factors can vary in different countries. We wanted to know the situation in an Indian centre. Materials and Methods: Data regarding age, sex, affected side, mode of injury, distribution of paralysis, associated injuries, pain at the time of presentation and the index procedure they underwent were collected from 304 patients. Additional data like the vehicle associated during the accident, speed of the vehicle during the accident, employment status and integration into the family were collected in 144 patients out of the 304 patients. Results: Road traffic accidents accounted for 94% of patients and of the road traffic accidents 90% involved two wheelers. Brachial plexus injury formed a part of multitrauma in 54% of this study group and 46% had isolated brachial plexus injury. Associated injuries like fractures, vascular injuries and head injuries are much less probably due to the lower velocity of the vehicles compared to the western world. The average time interval from the date of injury to exploration of the brachial plexus was 127 days and 124 (40.78%) patients presented to us within this duration. Fifty-seven per cent had joined back to work by an average of 8.6 months. It took an average of 6.8 months for the global brachial plexus-injured patients to write in their non-dominant hand.

scholarly journals Accident Severity Prediction Using Data Mining Methods

2019 ◽  
pp. 528-536 ◽  
Author(s):  
S. Ramya ◽  
SK. Reshma ◽  
V. Dhatri Manogna ◽  
Y. Satya Saroja ◽  
G. Sanjay Gandhi
Keyword(s):  
Data Mining ◽  
Random Forest ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Analytical Data ◽  
Developed Countries ◽  
Influential Factors ◽  
Living Environment ◽  
Severity Prediction ◽  
Accident Severity

The smart city concept provides opportunities to handle urban problems, and also to improve the citizens’ living environment. In recent years, road traffic accidents (RTAs) have become one of the largest national health issues in the world and it is leading cause for deaths. The burden of road accident casualties and damage is much higher in developing countries than in developed countries. Many factors (driver, environment, vehicle, etc.) are related to traffic accidents, some of those factors are more important in determining the accident severity than others. The analytical data mining solutions can significantly be employed to determine and predict such influential factors among human, vehicle and environmental factors. In this research, the classification technique i.e., Random forest algorithm is used to identify relevant patterns and for classifying the type of accident severity of various traffic accidents with the help of influential environmental features of RTAs that can be used to build the prediction model. This technique was tested using a real dataset. A decision system has been built using the model generated by the Random Forest technique that will help decision makers to enhance the decision making process by predicting the severity of the accident.

scholarly journals Epidemiological characteristics of road traffic injuries in AP Vojvodina

2009 ◽  
Vol 62 (1-2) ◽  
pp. 17-22 ◽  
Author(s):  
Predrag Djuric ◽  
Marica Miladinov-Mikov
Keyword(s):  
Mortality Rate ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Developed Countries ◽  
Road Traffic Accidents ◽  
Population Number ◽  
Road Traffic Injuries ◽  
Car Accidents ◽  
Internal Affairs ◽  
Epidemiological Characteristics

Introduction. Traffic accidents are one of the leading epidemiological problems in developed countries as well as in developing ones. It is estimated that every day in the world 1308 person die in car accidents. Causes of traffic accidents are factors of road, vehicle and human factors, the latter one being the cause of more than 90% car accidents, isolated or linked with other factors. Material and methods .Data from the Ministry of Internal Affairs - Department in Novi Sad were collected for the period 1992 - 2001 and analyzed. All road traffic accidents were divided into those with and without injured persons. All injured were divided in three categories: slightly injured, severely injured and killed. Categorisation was done by the Ministry of Internal Affairs (police). Results. Avarage number of road traffic accidents in AP Vojvodina is 13,191, and 3502 with injured persons per year. Avarage incidence is 174 accidents per 100,000 population, and 301 injured per 100 000 population. Mortality rate is 30.6 per 100 000 population. Number of killed in road traffic accidents per 10,000 vehicles is 6.91. Discussion. During the 1992-2001 period, morbidity and mortality rates of traffic accidents in AP Vojvodina were high. Participating of bicycle drivers, car passengers and pedestrians is higher than in developed countries. Injured persons are mostly 20-29 y.o., but rates of killed persons are the same in all age groups older than 19. Men are more in danger than women. Majority of accidents happen during the early autumn months, on Fridays and Saturdays, in early evening hours. Most persons have been injured or killed in city accidents,along Subotica-Belgrade highway. Conclusion. AP Vojvodina had the highest mortality rate of road traffic injuries per ten thousand vehicles in Europe - 6.91. Effective preventive meausres are needed to decrease rates of road traffic accidents.

Gastrointestinal Perforation in Children Due to Blunt Abdominal Trauma in Hazara, Northern Pakistan

2003 ◽  
Vol 33 (3) ◽  
pp. 168-170 ◽  
Author(s):  
Arshad Zafar ◽  
Nasir Orakzai ◽  
Aamir Ghafoor ◽  
Sajjad Ahmad
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Gastrointestinal Perforation ◽  
X Rays ◽  
Associated Injuries ◽  
Simple Closure ◽  
Single Region ◽  
Mean Time

A retrospective study of 25 children with gastrointestinal perforation due to blunt abdominal trauma in a single region of Pakistan is presented. The age, sex, aetiology, site of perforation, abdominal and X-ray findings, associated injuries, surgical procedures and outcome were analysed. There were 20 boys and 5 girls: mean age was 10 years. The injuries were the result of road traffic accidents 12 (48%), falls 11 (44%) and ‘struck by animals’ two (8%). Associated injuries occurred in 19 (76%). On admission 20 (80%) patients had peritonitis while 18 (72%) had pneumoperitoneum. Mean time from trauma to admission was 10 hours and admission to operation was 5 hours. Ileum was the most common site of perforation. Simple closure was the most common surgical procedure. Complications occurred in nine (36%) patients — six (24%) died. Delay in presentation and operation was associated with increased morbidity and mortality. Frequent evaluation of the child and abdominal X-rays are still the important tools for early diagnosis of gastrointestinal perforation following blunt abdominal trauma.

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