Hemoperitoneum Due to Penetrating Intercostal Artery Injury: A Case Report of a Rare and Still Understudied Entity

Intercostal artery injury may be life-threatening and usually presents as hemothorax. We report a unique case of penetrating injury, causing hemoperitoneum due to intercostal artery injury, without thoracic involvement. During urgent laparotomy, no intra-abdominal organ injury was found. Hemostasis was successfully achieved via suturing through an additional lateral 10cm incision through the left thorax.

Fireworks Ocular Injury in Saudi Children; Profile and Management Outcomes

Background: To explore the demographic profiling, causes, types, complications, management outcomes, and severity of fireworks- inflicted ocular injuries and traumas in children in KSA.Methods: This is a retrospective study of 115 cases with eye injuries managed at the Emergency Department, of our institution between 2003 and 2019. Demography, clinical features at presentation, mode of management and the Best Corrected Visual Acuity (BCVA) were evaluated at the last follow up. Results: The study included 117 eyes of 115 children [median age: 9 years; 96 (83.5%) boys; 19(16.5%) girls]. Fifty-six (48.7%) participants were bystanders. The injuries were caused mainly due to bangers (n=47; 40.9%), rockets in bottle (n=28; 24.3%), firecrackers (n=27; 23.5%), and nonspecific reasons (n=13; 11.3%). The children had presented with various severity levels: corneal abrasion (n=52; 44.4%); cataract (n=47;40.2%); penetrating injury (n=40; 34.2%); secondary glaucoma (n=22;18.8%); subluxated lens (n=19;16.2%); limbal stem cell deficiency (n=14;12.0%); Iridodialysis (n=12;10.3%), and vitreous hemorrhage (n=11;9.4%). Management interventions of the eyes under study included: penetrating injury repair (n=40; 34.2%), lens removal plus intraocular lens implantation (n=26; 22.2%), removal of foreign body (n=9; 7.7%). The BCVA after six months was 20/20- 20/60 in 49(41%) cases; 20/70 - 20/200 in 27 (23.1%) cases; <20/200-20/400 in 7 (6%) cases, and <20/400 in 34(29.1%) of the cases. Out of 51.3% eyes with <20/200 before management, only 35% recorded severe visual impairment.Conclusion: Fireworks-related eye injuries were mainly observed in boys primarily due to the use of bangers . Visual disability remained in one-third of the managed cases.

Ocular TASER Probe Injury Managed with Primary Evisceration: Case Report

A 34-year-old male presented to the emergency department with a penetrating injury of the left globe and orbit from a Thomas A Swift’s Electric Rifle (TASER^®) probe. The severity of the globe injury precluded primary closure of the globe; a primary evisceration was performed. In this article, we discuss not only the case in detail but also the TASER^® rifle and the literature to support our decision in performing an evisceration rather than an enucleation, which historically has been taught to decrease the risk of sympathetic ophthalmia (SO) in the fellow eye. We are of the opinion, after reviewing the literature, that SO is not an overwhelming reason to choose enucleation over evisceration and that evisceration has an advantage over enucleation with regard to functional and cosmetic outcomes.