Traumatic gastric rupture following blunt abdominal trauma: a case report about an atypical modality of presentation

Gastric rupture following blunt abdominal trauma is a rare presentation with a reported incidence of 0.02-1.7% in current literature. Traumatic gastric rupture is usually associated with other visceral injuries, such as splenic lesions and fractures. Prompt diagnosis and early intervention reduce mortality and morbidity. History of a recent meal has been implicated in traumatic gastric rupture. 2 We report a case of blunt abdominal trauma with an isolated gastric rupture after a motor vehicle accident, managed successfully without any post-operative morbidity and mortality.

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Challenges in management of blunt abdominal trauma: a prospective study

International Surgery Journal ◽

10.18203/2349-2902.isj20184078 ◽

2018 ◽

Vol 5 (10) ◽

pp. 3298

Author(s):

Rajkumar P. N. ◽

Kushal Kumar T. R. ◽

Deepak G.

Keyword(s):

Prospective Study ◽

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Imaging Modality ◽

Tertiary Care ◽

Organ Injury ◽

Solid Organ ◽

Vehicle Accident

Background: Trauma meets the pandemic criteria, with a daily worldwide mortality as high as 16000. Abdominal trauma remains a leading cause of mortality in all age groups. Blunt abdominal trauma (BAT) mainly results from motor vehicle accident, fall from height and assaults. The commonest organ injured is the spleen, followed by the liver and small bowel. Lately, the management of BAT has changed from operative to non-operative management. This study was done to analyse the incidence, patterns, current management practiced, and challenges encountered in BAT treated operatively.Methods: This Prospective study was conducted in tertiary care centre in Bangalore during August 2015 to December 2017. 475 patients with blunt abdominal injuries who reported to emergency department were selected for the study based on following inclusion and exclusion criteria.Results: A total of 475 cases of BAT were assessed with a mean age of males and females was 32.6 and 28.3year respectively. Most patients (65%) were between 21 to 30 years of life. Most common mode of injury was motor vehicle accident (57.68%), 60% patients presented to hospital within the initial 4 hours. Abdominal CT had highest accuracy. Most common solid organ injury being spleen (26.5%). 80.84% patients were selected for SNOM and 15.62% had Failed SNOM. 28.48% patients had complications with most common complication wound infection followed by aspiration pneumonia and 7 patients had mortality.Conclusions: Initial resuscitation with thorough clinical examination with correct usage of imaging modalities with timely and proper decision making is the key of management of patients with BAT and there is a need to identify newer imaging modality/procedure which helps to determine better management scheme in all blunt trauma patients.

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Blunt abdominal trauma in Sanglah Hospital Bali, Indonesia: a study of 65 cases

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20193951 ◽

2019 ◽

Vol 7 (9) ◽

pp. 3575

Author(s):

Putu Gosen Partama ◽

Made Agus Dwianthara Sueta

Keyword(s):

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Hypovolemic Shock ◽

Organ Damage ◽

Retroperitoneal Haematoma ◽

Common Cause ◽

Vehicle Accident ◽

Common Clinical Presentation

Abdominal trauma is a challenge for every surgeon, whether related to diagnosis or treatment. In developing countries, the number of traumatic events associated with death makes it necessary for a study to be carried out to see the patterns and damage caused by abdominal trauma and the organs involved. Material and Method is all patients with blunt trauma of the abdomen who came to emergency unit Sanglah Hospital Bali, from January 2017 up to May 2018 that undergo laparotomy exploration were enrolled, the data were collected retrospectively using patient medical records. Results is 65 patients with blunt abdominal trauma came to the emergency department and undergoes laparotomy exploration, range of age was 4-74 year old and 75.3% of them were men. The most common injured organs were spleen and liver, both are 26 and 15 cases (40 and 23%). Another intraoperative finding are Ileum Perforation (10 cases) Left Zone II Retroperitoneal Haematoma (7 cases), and Mesenterium Rupture (5 cases). Splenectomy was the most performed procedure (26 cases). The most common cause of blunt abdominal trauma was motor vehicle accident. Hypovolemic shock was the most common clinical presentation (48 patient). The Conclusions are according to this study, men consisted 75.3% cases of blunt abdominal trauma and the range age of patients was 4-74 year old. The most common cause was motor vehicle accident. Among patients with intra-abdominal organ damage, spleen and liver were most commonly involved. About 84.6% of all patients with blunt abdominal trauma were discharged without complication and morbidity.

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An analysis of injury patterns of abdominal trauma in patients attending surgical emergency department of rural hospital, Karnataka, India

International Surgery Journal ◽

10.18203/2349-2902.isj20174897 ◽

2017 ◽

Vol 4 (11) ◽

pp. 3736

Author(s):

Narasimhaiah Krishnappa ◽

Asif Khan ◽

Saraswathi Sakranaik

Keyword(s):

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Public Health Problem ◽

Major Public Health Problem ◽

Trauma Patients ◽

Abdominal Injuries ◽

Mortality And Morbidity ◽

Revised Trauma Score

Background: Globally, abdominal trauma is a major public health problem irrespective of socioeconomic levels. Severe blood loss and infection are the serious complication of any abdominal trauma. A detailed assessment for early identification and prompt management is required to reduce the mortality and morbidity in any abdominal trauma. Hence this study was designed to assess the incidence and patterns of abdominal injuries in trauma patients.Methods: It was assorted and identified the incidence and sub type of abdominal injuries and associated trauma, and identified variables related to morbidity and mortality.Results: A total of 150 abdominal trauma cases were analyzed; 103 patients with blunt abdominal trauma and 47 with penetrating. The most frequent type of abdominal trauma was blunt trauma; its most common cause was motor vehicle accident. Most abdominal trauma patients presented with other injuries, especially patients with blunt abdominal trauma. Mortality was higher among penetrating abdominal trauma patients.Conclusions: Type of abdominal trauma, associated injuries, and Revised Trauma Score are independent risk factors for mortality in abdominal trauma patients.

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Early Identification of Traumatic Durotomy Associated with Atlantooccipital Dislocation May Prevent Retropharyngeal Pseudomeningocele Development

Case Reports in Surgery ◽

10.1155/2015/361764 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4

Author(s):

Robert S. Qiu ◽

Mina G. Safain ◽

Max Shutran ◽

Alejandra M. Hernandez ◽

Steven W. Hwang ◽

...

Keyword(s):

Motor Vehicle ◽

Motor Vehicle Accident ◽

Csf Leak ◽

Rare Presentation ◽

Vehicle Accident ◽

C2 Nerve Root ◽

Csf Diversion ◽

The Right ◽

Atlantooccipital Dislocation ◽

Mri Image

Atlantooccipital dislocation can be complicated by a traumatic durotomy that may lead to the rare development of a retropharyngeal pseudomeningocele. To our knowledge this has been reported only five times previously. We present the case of a 60-year-old man involved in a motor vehicle accident who suffered an atlantooccipital dislocation and C5-C6 three-column injury. A unique MRI image of a defect in the ventral dura posterior to C2 was appreciated. He underwent occiput to T2 internal fixation and arthrodesis. During surgery, CSF egress was seen caudal to the right C2 nerve root. A DuraMatrix onlay patch reinforced with DuraSeal was placed to stop the CSF leak. A lumbar subarachnoid drain was also placed. The patient made a satisfactory recovery with residual mild weakness of his right upper extremity. In this report, we demonstrate that careful MRI review can reveal a ventral durotomy in a traumatic atlantooccipital dislocation and, if discovered, effective treatment including a lumbar subarachnoid drain for CSF diversion may prevent progression to a retropharyngeal pseudomeningocele. The literature on this rare presentation and associated durotomy is provided.

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A Rare Case of Spontaneous Bilateral Subcapsular Renal Hematoma

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/2324709620918098 ◽

2020 ◽

Vol 8 ◽

pp. 232470962091809

Author(s):

Tushar Bajaj ◽

Ngon Trang ◽

Faisal Nasrawi ◽

Sabitha Eppanapally

Keyword(s):

Diabetic Ketoacidosis ◽

Rare Case ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Disease Stage ◽

Close Monitoring ◽

Invasive Approach ◽

Subcapsular Hematoma ◽

Vehicle Accident ◽

History Of

Spontaneous bilateral renal subcapsular hematoma is a rare condition. On literature review, only 2 case reports have elucidated possible etiologies for such a presentation; however, no definite conclusions have been made. We present a rare case of a 52-year-old female with diabetes mellitus type 2, chronic kidney disease stage 4, hypertension, hyperlipidemia, prior traumatic brain injury via motor vehicle accident, who presented to our hospital with diabetic ketoacidosis and clinical signs of pyelonephritis; subsequently, imaging demonstrated spontaneous bilateral renal subcapsular hematoma. Risk factors for the rare presentation in this patient included pyelonephritis, history of bilateral ureteral stent placement, and a remote history of a mild unilateral renal laceration secondary to a motor vehicle accident. Typically, patients with this condition achieve spontaneous resolution with conservative management. Our patient initially presented with diabetic ketoacidosis and pyelonephritis but gradually developed retroperitoneal bleeding and hemorrhagic shock. Our patient’s critical condition required close monitoring in an intensive care unit and a more invasive approach including unilateral left renal artery embolization followed by a unilateral left nephrectomy. The patient ultimately recovered and continued to be followed outpatient without any serious long-term complications.

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An experience with blunt abdominal trauma: evaluation, management and outcome

Clinics and Practice ◽

10.4081/cp.2014.599 ◽

2014 ◽

Vol 4 (2) ◽

Cited By ~ 24

Author(s):

Nikhil Mehta ◽

Sudarshan Babu ◽

Kumar Venugopal

Keyword(s):

Early Diagnosis ◽

Abdominal Trauma ◽

Blunt Abdominal Trauma ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

World Health ◽

Common Mechanism ◽

World Population ◽

Diagnosis And Management ◽

Time Of Presentation

Blunt abdominal trauma (BAT) is a frequent emergency and is associated with significant morbidity and mortality in spite of improved recognition, diagnosis and management. Trauma is the second largest cause of disease accounting for 16% of global burden. The World Health Organization estimates that, by 2020, trauma will be the first or second leading cause of <em>years of productive life</em> <em>lost</em> for the entire world population. This study endeavors to evaluate 71 cases of BAT with stress on early diagnosis and management, increase use of non operative management, and time of presentation of patients. A retrospective analysis of 71 patients of BAT who were admitted in Kempegowda Institute of Medical Sciences hospital (KIMS, Bangalore, India) within a span of 18 months was done. Demographic data, mechanism of trauma, management and outcomes were studied. Most of the patients in our study were in the age group of 21-30 years with an M:F ratio of 3.7:1. Motor vehicle accident (53%) was the most common mechanism of injury. Spleen (53%) was the commonest organ injured and the most common surgery performed was splenectomy (30%). Most common extra abdominal injury was rib fracture in 20%. Mortality rate was 4%. Wound sepsis (13%) was the commonest complication. Initial resuscitation measures, thorough clinical examination and correct diagnosis forms the most vital part of management. 70% of splenic, liver and renal injuries can be managed conservatively where as hollow organs need laparotomy in most of the cases. The time of presentation of patients has a lot to do with outcome. Early diagnosis and prompt treatment can save many lives.

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Laparoscopic Repair of Diaphragmatic Rupture: A Case Report with Radiological and Surgical Correlation

Case Reports in Surgery ◽

10.1155/2017/4159108 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Patrick Nguyen ◽

Bonnie Davis ◽

Daniel D. Tran

Keyword(s):

Abdominal Trauma ◽

Laparoscopic Repair ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Diaphragmatic Rupture ◽

Delayed Presentation ◽

Vehicle Accident ◽

Chest X Ray ◽

The Many ◽

High Degree

The leading cause of diaphragmatic rupture is penetrating abdominal trauma, including gunshot- and stab-related wounds; however, diaphragmatic rupture can also result from blunt trauma to the abdomen. The diagnosis can be difficult to make as the physical examination may be unremarkable, and imaging, that is, a conventional chest X-ray and/or CT imaging, may initially fail to reveal the injury. Failure to recognize diaphragmatic rupture can result in a delayed presentation, sometimes years later, with a potential catastrophic outcome. Therefore, prompt and swift diagnosis is critical to avoid this potential harmful scenario. Traditionally, repair is performed through a laparotomy or a thoracotomy incision. Owing to the many advances made in minimally invasive surgery, not only has laparoscopy become the modality of choice to diagnose diaphragmatic rupture due to its high degree of sensitivity and specificity, but it can provide simultaneous therapeutic intervention as well. We report a case of laparoscopic repair of a diaphragmatic rupture in a 22-year-old female who sustained blunt abdominal trauma during a motor vehicle accident.

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RESTORASI PASAK FIBER DAN PORCELAIN FUSED TO METAL PADA FRAKTUR GIGI INSISIF RAHANG ATAS PASCA PERAWATAN ENDODONTIK

Andalas Dental Journal ◽

10.25077/adj.v1i1.15 ◽

2019 ◽

Vol 1 (1) ◽

pp. 71-77

Author(s):

Deli Mona ◽

Endang Sukartini

Keyword(s):

Motor Vehicle ◽

Motor Vehicle Accident ◽

Resin Composite ◽

Endodontic Treatment ◽

Fiber Post ◽

Vehicle Accident ◽

Resin Core ◽

Long Time ◽

History Of ◽

Glass Fiber Post

Teeth with is treated with endodontic treatment has own problems, tends to be weaker because of dentin removal and reduced moisture content, so, requires post and crown restoration treatment. The principle of making restoration should be to restore function, esthetic, and to distribute chewing load, so, both teeth and its crown can be used in a long time in oral cavity. This case report described about 23-year-old female patient with a history of truma motor vehicle accident. Tooth 11,12,21 was fractured 2/3 crown with pulp exposed. The diagnosis which estabilished for this case is irreversible pulpitis and the treatment planning are one visit root canal treatment, post and fiber insertion and porcelain fused to metal restoration. On the first visit, acces preparation with crown down technique was done and rootcanals filled with gutta percha and sealer AH 26 with lateral condensation technique. Fiber post was insertion in next visit and cementation with dual-cured resin. Core was made in resin composite and porcelain fused to metal was inserted after control of patient condition in 1 week. One of those methods that used in this case is prefabricated glass fiber post, because of its biocompatibility, more aesthetic, has a modulus of elasticity which is resemble with dentine. Pressure that its transmitted by post to dentin is low, so, this is minimize a root fractured. The result of this treatment and the restoration was good, there were no patient complaints, and normal gingival seemed around the teeth. Restoration post endodontic treatment can be done with several techniques, one is post and porcelain fused to metal to produce a good restoration.

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Profile of Abdominal Trauma Patient Underwent Surgery in Emergency Operating Room of Sanglah General Hospital from January until December 2015

JBN (Jurnal Bedah Nasional) ◽

10.24843/jbn.2018.v02.i01.p01 ◽

2018 ◽

Vol 2 (1) ◽

pp. 1

Author(s):

Reza Halim ◽

Made Agus Dwianthara Sueta

Keyword(s):

General Hospital ◽

Operating Room ◽

Abdominal Trauma ◽

Medical Records ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Trauma Patients ◽

Vehicle Accident ◽

Liver Repair ◽

Emergency Operating

Objective: to investigate the characteristics of patients, presentation of the abdominal organ that involved, and clinical data associated with this event. Methods: this is a descriptive study with retrospective design. Total samples were all patients with abdominal trauma who underwent surgery on the emergency operating theatre of Sanglah General Hospital between January and December 2015. Baseline data of patients were obtained from the medical records. Results: within the study period, a total of 104 patients with abdominal trauma who underwent surgery in the emergency operating room of Sanglah General Hospital were identified. Man comprised 87.5% of the patients and mostly were 17-45 years old (75%). The motor vehicle accident occurred majority on the weekend (65%). Liver and spleen were the most affected organ (55%). Splenectomy (35%) and liver repair surgery (33%) were the most often performed procedures. Conclusion: Abdominal trauma caused by motor vehicle accident occurred mostly on the weekend. Two most affected organs in abdominal trauma were liver and spleen. Splenectomy and liver repair surgery were the procedures performed for these trauma patients.

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Traumatic shock and altered mentality following motor vehicle accident

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907920913657 ◽

2020 ◽

pp. 102490792091365

Author(s):

Youngeun Park ◽

Byungchul Yu ◽

Giljae Lee ◽

Jungnam Lee

Keyword(s):

Computed Tomography ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Traumatic Shock ◽

Diagnostic Methods ◽

Computed Tomography Scan ◽

Mortality And Morbidity ◽

Vehicle Accident ◽

Tomography Scan ◽

Significant Mortality

Traumatic atlanto-occipital dislocation is associated with significant mortality and morbidity. We present an 18-year-old female who visited the emergency department after a motor vehicle accident. A cervical spine computed tomography scan showed the postero-inferior atlanto-occipital dissociation and several diagnostic methods coincided with the diagnosis of atlanto-occipital dislocation.

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