scholarly journals Rare but Foreseeable: Rapidly Expanding Retropharyngeal Hematoma After Fall from Height

2021 ◽  
Vol 2 (5) ◽  
pp. 255-257
Author(s):  
Alexander Bracey ◽  
Christine Ahn ◽  
Ryan Barnicle ◽  
Michael Frost ◽  
Marshall Leonard ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Rapid Decline ◽  
Airway Compromise ◽  
Initial Examination ◽  
Case Presentation ◽  
Cervical Fractures ◽  
Trauma Service ◽  
Fall From Height ◽  
Retropharyngeal Hematoma ◽  
Set Up

Case Presentation: An elderly man presented to the emergency department after a fall from a 15-foot height. Initial examination revealed signs of head and neck trauma without airway compromise. Computed tomography imaging identified cervical fractures at the first and second level with a retropharyngeal hematoma. In discussion with the trauma service, the patient was admitted to the hospital for airway monitoring. After 10 hours he clinically deteriorated, resulting in acute respiratory failure, and ultimately required intubation. The patient was intubated with a hyperangulated video laryngoscopy, and a surgical set-up was also prepared. The intubation was uncomplicated and resulted in clinical improvement. The patient was extubated after three days without difficulty and was ultimately discharged following an uncomplicated hospital course. Discussion: Retropharyngeal hematoma is a rare but significant clinical condition. Rapid decline and airway compromise have been described. Patients often require intubation and mechanical ventilation to avoid airway obstruction and respiratory failure. Coagulopathies should be reversed, if present. Prompt recognition and treatment of this condition is crucial to successful management.

Traumatic respiratory failure and veno-venous extracorporeal membrane oxygenation support

Perfusion ◽  
2021 ◽  
pp. 026765912110128
Author(s):  
Ismael A Salas De Armas ◽  
Bindu Akkanti ◽  
Pratik B Doshi ◽  
Manish Patel ◽  
Sachin Kumar ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Injury Severity ◽  
Invasive Mechanical Ventilation ◽  
Ecmo Support ◽  
Trauma Patients ◽  
Membrane Oxygenation ◽  
Trauma Service ◽  
Proper Patient Selection ◽  
Vv Ecmo

Background: Respiratory failure (RF) is a common cause of death and morbid complication in trauma patients. Extracorporeal membrane oxygenation (ECMO) is increasingly used in adults with RF refractory to invasive mechanical ventilation. However, use of ECMO remains limited for this patient population as they often have contraindications for anticoagulation. Study design: Medical records were retroactively searched for all adult patients who were admitted to the trauma service and received veno-venous ECMO (VV ECMO) support between June 2015 and August 2018. Survival to discharge and ECMO-related complications were collected and analyzed. Results: Fifteen patients from a large Level I trauma center met the criteria. The median PaO2/FiO2 ratio was 53.0 (IQR, 27.0–76.0), median injury severity score was 34.0 (IQR, 27.0–43.0), and the median duration of ECMO support was 11 days (IQR, 7.5–20.0). For this cohort, the survival-to-discharge rate was 87% (13/15). The incidence of neurologic complications was 13%, and deep vein thrombosis was reported in two cases (13%). Conclusions: Survival rates of trauma patients in this study are equivalent to, or may exceed, those of non-trauma patients who receive ECMO support for other types of RF. With the employment of a multidisciplinary team assessment and proper patient selection, early cannulation, traumatic RF may be safely supported with VV ECMO in experienced centers.

scholarly journals Acute celiac artery occlusion secondary to blunt trauma: Two case reports

2020 ◽  
Author(s):  
Hui Li ◽  
Yu Zhao ◽  
Yan-an Xu ◽  
Tao Li ◽  
Jun Yang ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Case Reports ◽  
Celiac Artery ◽  
Artery Occlusion ◽  
Severe Liver ◽  
Case Presentation ◽  
Artery Injury ◽  
Vehicle Collision ◽  
Fall From Height ◽  
The Right

Abstract Background Blunt celiac artery injury is extremely rare, but it is easy to ignore. The clinical manifestation of celiac artery injuries is usually atypical, so it is easy to fail to diagnose them. Case presentation: We report two cases of celiac artery occlusion after multiple trauma admitted, its mechanisms were motor vehicle collision and fall from height, respectively. The first patient was combined with severe liver injury, and the right hepatic arterial was embolized with coil assisted by the operation through the superior mesenteric artery. Both patients were managed with non-operation treatment, and no complications occurred during hospitalization. Conclusions For patients with celiac artery injury, conservative treatment is an important choice, but successful treatment still needs to be individualized based on the patient's condition.

Comparison of Rheological Measurement Techniques for Semi-Solid Aluminium Alloys

2006 ◽  
Vol 116-117 ◽  
pp. 610-613 ◽  
Author(s):  
Andreas Bührig-Polaczek ◽  
C. Afrath ◽  
Michael Modigell ◽  
Lars Pape
Keyword(s):  
Shear Rate ◽  
Measurement Techniques ◽  
Casting Machine ◽  
Wall Slip ◽  
Compression Tests ◽  
Concentric Cylinder ◽  
Initial Examination ◽  
Rheological Measurement ◽  
Semi Solid ◽  
Set Up

Alloys of a specific microstructure exhibit a shear-rate history-dependent flow behaviour in the semi-solid state. Rheological studies have been carried out using various experimental techniques such as concentric cylinder rheometers of Couette or Searle type as well as capillary rheometers and parallel plate compression tests. With the Searle type rheometer and the capillary rheometer two different approaches of rheological measurement techniques are discussed and compared regarding advantages, potentials and its distinct characteristics. Experiments using the Searle type rheometer have been conducted under steady-state or oscillating conditions and have been used to verify time-dependency of step responses due to discontinuous or linear variances of the shear rate. These experiments provide all types of flow curve parameters as implemented in the numerical simulation. However the variances of the commonly used Couette and Searle type rheometers are limited to shear-rates which are significantly lower than that appearing in the technical thixo- or rheocasting processes. For that reason an additional experimental set-up with a horizontal slot capillary integrated in a shot-controlled high-pressure die-casting machine is used in order to examine flow properties at shear rate conditions similar to those in real thixocasting processes. After an initial examination of low temperature model alloys, such as PbSn15, the experimental set-up is then adjusted in order to obtain rheological data for light metal alloys such as Aluminium AlSi7Mg0.3. The Aluminium alloy is processed within each rheometer either as partially solidified or partially remelted in order to represent conditions of both, the conventional thixocasting and the lately introduced rheocasting process. Finally the appearance of physical phenomena which affects the accuracy of rheological experiments such as wall slip is considered for both types of rheometers.

scholarly journals Respiratory Failure Following Interscalene Block for the Treatment of Shoulder Dislocation in a Patient with COVID-19

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Elham Mousavi ◽  
Masood Mohseni
Keyword(s):  
Respiratory Failure ◽  
Shoulder Dislocation ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Pulmonary Involvement ◽  
Interscalene Block ◽  
Intravenous Sedation ◽  
Ultrasound Guided ◽  
Case Presentation ◽  
Phrenic Nerve Block

Introduction: Guidelines recommend the use of regional anesthesia for patients with COVID-19, when possible. Interscalene block (ISB) is the standard care for analgesia of shoulder surgery. Hemidiaphragmatic paresis due to phrenic nerve block is expected in ISB but is usually well-compensated. We present a patient with pulmonary involvement of COVID-19 candidate for the surgery of shoulder dislocation under ISB who experienced respiratory failure after the block. Case Presentation: A 36-year-old female patient with COVID-19 developed a shoulder dislocation following a seizure. Relocating the joint was successfully attempted under intravenous sedation and ultrasound-guided ISB. The patient developed respiratory distress due to hemidiaphragmatic paresis after the block. She was managed using a continuous positive airway pressure (CPAP) mask for 48 hours until the pulmonary condition improved. Conclusions: Anesthetists should prepare themselves to replace ISB with diaphragm-sparing blocks or apply techniques to reduce the chance of hemidiaphragmatic paresis after ISB in patients with COVID-19.

scholarly journals Anesthetic management of a 12-year-old child with Kagami-Ogata syndrome for pectus excavatum: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Hisako Nishimoto ◽  
Masahiro Yagihara ◽  
Aki Uemura ◽  
Yoshiki Nakajima
Keyword(s):  
Gene Expression ◽  
Mechanical Ventilation ◽  
Case Report ◽  
Respiratory Failure ◽  
Pain Control ◽  
Pectus Excavatum ◽  
Anesthetic Management ◽  
Respiratory Pattern ◽  
Airway Patency ◽  
Case Presentation

Abstract Background Kagami-Ogata syndrome (KOS) is due to abnormal gene expression in the 14q32.2 imprinted region. Laryngomalacia and bell-shaped thorax of children with KOS can affect airway management of general anesthesia. Case presentation A 12-year-old girl with KOS had a mechanical ventilation history and underwent pectus excavatum repair for cosmetic reasons. Although she had undergone invasive thoracic surgery under general and epidural anesthesia, her respiratory rate and tidal volume were stable with adequate pain control mainly through epidural analgesia at the end of the surgery. We examined her larynx by a bronchoscope. Then, we successfully extubated her after confirming the normal movement of her larynx. Conclusions When patients with KOS undergo pectus excavatum repair, anesthesiologists should prevent postoperative respiratory failure by providing adequate postoperative analgesia. Evaluation of airway patency and respiratory pattern before extubation is critical.

scholarly journals UMBILICAL METASTASIS MIMICKING SYMPTOMATIC UMBILICAL HERNIA - A RARE CASE REPORT AND REVIEW OF THE LITERATURE

2020 ◽  
Vol 18 (2) ◽  
pp. 161-164
Author(s):  
Iv. Novakov
Keyword(s):  
Umbilical Hernia ◽  
Rare Case ◽  
Medical Literature ◽  
Review Of The Literature ◽  
Solid Mass ◽  
Initial Examination ◽  
Case Presentation ◽  
Umbilical Metastasis ◽  
Rare Case Report ◽  
Sister Mary Joseph’S Nodule

Umbilical metastases, also termed Sister Mary Joseph's nodule, are reported rarely in medical literature and they are associated with advanced metastatic intra-abdominal and pelvic cancers. The purpose of this publication is to report a rare case of umbilical metastasis misdiagnosed as acomplicated umbilical hernia. Case presentation. A 74-years-old woman with nausea and painful umbilical swelling was misdiagnosed as incarcerated umbilical hernia оn the initial examination. Abdominal computed tomography revealed a huge pelvic cystic-solid mass, probably originates from right ovary. Conclusion. In conclusion, the presented case demonstrated that due to the lack of understanding Sister Mary Joseph’s nodule could be easily mistaken for incarcerated umbilical hernia.

Massive Retropharyngeal Hematoma with Airway Obstruction after Minor Injury

2017 ◽  
Vol 14 (02/03) ◽  
pp. 095-097
Author(s):  
Shivender Sobti ◽  
Sarvpreet Grewal ◽  
Paul John ◽  
Ashwani Grover
Keyword(s):  
Airway Obstruction ◽  
Airway Compromise ◽  
Minor Injury ◽  
Life Threatening ◽  
Retropharyngeal Hematoma

AbstractRetropharyngeal hematoma can cause life-threatening airway compromise. We present a case of massive retropharyngeal hematoma following minor injury. The patient required immediate tracheostomy followed by evacuation of hematoma and cervical stabilization.

scholarly journals Traumatic Retropharyngeal Hematoma in a Patient Taking Clopidogrel

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
David P. Betten ◽  
Jennifer L. Jaquint
Keyword(s):  
Symptom Onset ◽  
Elderly Woman ◽  
Antiplatelet Agents ◽  
Airway Compromise ◽  
Delayed Onset ◽  
Life Threatening ◽  
Retropharyngeal Hematoma ◽  
Life Threatening Event

The development of a retropharyngeal hematoma may lead to acute airway compromise requiring emergent airway stabilization. We describe the development of a retropharyngeal hematoma in an elderly woman who sustained a fall from standing approximately 10 hours prior to symptom onset who was taking the antiplatelet agents clopidogrel and aspirin. This delayed onset of rapid airway compromise secondary to a retropharyngeal hematoma following a fall in a patient taking clopidogrel is an unusual and potentially life threatening event.

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