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Blunt traumatic rupture of the heart carries a high mortality rate. Anatomical injuries have included the atrium, appendage and ventricle but injury to the left appendage has been reported very rarely. We present the case of a 71-year-old female who was a driver in a motor collision with major front-end damage where air bags were deployed. After being intubated and receiving pericardiocentesis for cardiac tamponade at an advanced critical care and emergency medical center, the patient was taken to our hospital and emergently to the operating room for exploration. There was brisk bleeding coming from a 2 cm laceration on the left atrial appendage. The injury was repaired using 4-0 polypropylene felt pledget-supported horizontal mattress sutures on the beating heart with the assistance of cardiopulmonary bypass. The present report describes this patient and our findings from a literature review.
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Background: Blunt abdominal trauma is fairly common emergency and it is one of the important components of polytrauma. It requires high degree of suspicion, investigation and management. Inspite of improved imaging techniques leading to early recognition it is still associated with high morbidity and mortality. Trauma is the leading cause of blunt abdominal injury. This aim of the study was to find etiology, early diagnosis and management of patients with blunt abdominal trauma.Methods: This a retrospective study conducted in Gandhi medical college, Bhopal in which 90 cases of blunt abdominal trauma presented to emergency and outpatient department were included in the study duration of January 2019 to December 2019.Results: Motor vehicle accident was the most common mode of injury. Liver being the most common visceral organ injured while the most common surgery performed was the repair or resection and anastomosis of hollow viscous perforation. Rib fracture was the most common extra abdominal injury seen in 17.7% cases. Mortality rate was 5.5%. Most of the liver, spleen and renal injuries can be managed non-operatively whereas hollow viscous injury needs laparotomy.Conclusions: The result of present study is similar to other studies. Rapid diagnosis, early and timely referral, adequate and trained staff, close and careful monitoring, early wise and skilled decision to go for operative or non-operative management can help save many lives.
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Aims: To study the types of all possible injuries in different age groups and its prevalence in the Saudi society, especially in the city of Jeddah and its causes. Study Design: A prospective study with a special questionnaire to collect data. Place and Duration of Study: Department of Radiology (X-ray Unit), King Abdulaziz University Hospital, Jeddah, Saudi Arabia, for 6 months. Methodology: A questionnaire developed by the authors was used to collect data. The questionnaire had two parts. The first part was used to collect demographic data, and the second part was used to determine the type of injuries (trauma, motor vehicle accident, sudden and chronic). The subjects of the survey were chosen randomly from the radiology department at King Abdulaziz University Hospital (KAUH). Then, SPSS 15.0 for Windows was used for statistical analyses. Data are presented using descriptive statistics and were analyzed using the chi-squared test. Results: The participants (subjects) were male (56.5%) and female (43.5%) that had a mean age of 28.98±1.09 years, a mean height of 148.02±1.55 cm, and a mean mass of 58.71±1.63 kg. The older adults were the majority (32.2%) in this study followed by pediatric (30.6%) where the immune is lower than the other age groups’ categories and is more affected by musculoskeletal injuries. The common injuries of the different musculoskeletal system were explored and obtained. That the highest percentage is related to trauma (58.9%) in all age groups, where the dominant percentage in trauma was in the pediatric age group (27.6%). Through our study, it was found that there is a high significant relationship (p < 0.05) with a degree of freedom is (df=12) between age groups and type of injuries for all genders. Conclusion: More education needs to be provided for our community in preventing and limiting personal injury especially in younger age groups.
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Objective To evaluate the curative effects of intravenous methylprednisolone (IVMP) during the conservative management for patients with indirect optic nerve injury (ONI),and to analyze the benefits of visual evoked potential (VEP) monitoring in prognosis assessment.Methods Among the 253 patients with cranial-facial injury,108 sufferred from optic nerve injury including 89 cases without optic nerve decompression treatment.These 89 patients were randomly divided into:group A,in which patients were given methylprednisolone intravenously for 7 days; and group B,in which patients without methylprednisolone treatment.The extent of and time required for eyesight recovery were recorded.VEP measurement was carried out in all cases.Results No differences in gender,age and BMI (Body Mass Index,all P ＞ 0.05) were observed.The incidence of ONI was higher in patients with motorcycle accident than that in those with car accident (P ＜0.01).In the motorcycle accidents,casualties wearing a helmet had lower incidence of ONI (P ＜ 0.01).Patients treated with methylprednisolone had a shorter recovery time (P ＜ 0.01) from blindness,however there was no difference in long-term outcome between group A and B.In patients with visual improvement in the “ non-extinguished” group,the amplitude and latency of the P wave of VEP were markedly ameliorated after the treatments (P ＜ 0.01).Conclusions Most of the ONI casualties in our study were resulted from motorcycle accidents,and wearing a helmet is an effective protection measure.The intravenous methylprednisolone (IVMP) showed no effect on improving the prognosis in patients with conservative treatment.The IVMP shortened the recovery time at the expense of increase in risk of complications.VEP examination is beneficial in prognosis assessment for non-operative ONI patients.The improvement of the amplitude and latency of P wave has close correlations with patients'visual recovery.
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This is a retrospective study to determine the distribution site, associated fracture and causes of mandibular fractures at HUSM, over a 5 year period, from 1st January 2002 – 31st December 2006. Records of patients who had mandibular fracture were reviewed. Data of age, sex, site of fracture, causes and associated fracture were recorded and analyzed using SPSS version 15.0. There were 113 (84.3%) males and 21 (15.7%) females. The mean age for male was 84.3% and female was 15.7%. The fracture occurs mostly at the age of 11-20 years (45.5%), followed by 21-30 years (30.6%). Motor vehicle accidents (MVA) were the commonest causes of mandibular fracture (92.5%), followed by fight and assault (3.7%), industrial accidents (3.0%), fall (0.7%). There were no cases recorded due to sport injury. The commonest site of mandibular fracture occurs at angle and para-symphysis (23%), followed by body (20.1%), symphysis (16.7%), condyle (15.5%) and ramus (1.7%). The most common associated fractures were head injury (23.5%), followed by clavicle fracture (17.2%) and fracture of radius (10.7%). Mandibular fracture was common in males with the mean age 24.63 years and mostly due to MVA. Angle and para-symphysis is the commonest site of mandibular fracture with most of the patient suffered from concomitant head injury.
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O atropelamento por veículos automotivos contribui significativamente para as estatísticas de morte em cães. Entretanto, há poucos estudos sobre os aspectos patológicos reportados na literatura. Este artigo descreve 155 casos fatais de atropelamento por veículos automotivos em cães. Dos 155 cães atropelados, em 138 (89,0 por cento) havia lesões que explicavam a morte ou a razão para a eutanásia desses cães. Essas lesões incluíram traumatismo espinhal-medular (43 [27,7 por cento]), ruptura de órgãos parenquimatosos (40 [25,8 por cento]), traumatismo cranioencefálico (28 [18,1 por cento]), ruptura de órgãos ocos (16 [10,3 por cento]), fratura de costelas com laceração de órgãos parenquimatosos (15 [9,7 por cento]) e ruptura de diafragma com deslocamento de vísceras abdominais para a cavidade torácica (10 [6,4 por cento]).
Motor vehicle-related trauma significantly contributes to death statistics of dogs. There are however few documented reports on the pathological aspects of such cases. This paper describes 155 fatal cases of dogs victimized by motor vehicle accidents. In 138 (89.0 percent) of the 155 dogs hit by motor vehicles there were lesions that could explain the death or reason for these dogs being euthanatized. These lesions included vertebrospinal trauma (43 [27.7 percent]), rupture of parenchymal organs (40 [25.8 percent]), cranioencephalic trauma (28 [18.1 percent]), rupture of hollow organs (16 [10.3 percent]), rib fracture with subsequent laceration of parenchymal organs (15 [9.7 percent]), and diaphragmatic rupture with displacement of abdominal viscera into the thoracic cavity (10 [6.4 percent]).
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Air-bags have received widespread support as an effective means of enhancing automotive safety, and they are becoming more common as standard automobile equipment on many cars. Although air-bag induced ocular injuries are rare, they present a serious concern because of the possibility of permanent damage or visual impairment. To date, most reports have investigated ocular injury from high velocity motor vehicle accidents and reports of ocular injury from low speed motor vehicle accidents have been rare. We describe a patient who sustained severe ocular injury, including periorbital fracture, hyphema, vitreous hemorrhage, and choroidal rupture of the macular area, due to an inflated air-bag in a low speed motor vehicle accident.
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Adult , Female , Humans , Accidents, Traffic , Air Bags/adverse effects , Choroid/injuries , Eye Injuries/etiology , Hyphema/etiology , Orbital Fractures/etiology , Rupture , Tomography, X-Ray Computed , Vitreous Hemorrhage/etiologyABSTRACT
OBJECTIVES: This study aimed to report the incidence of chronic posttraumatic stress disorder (PTSD), to identify psychosocial risk factors posttraumatically affecting the severity of PTSD symptoms, to compare the pattern of symptom changes over time, and to find early self-rated measures for the prediction of chronic PTSD in the patients physically injured by motor vehicle accident. METHOD: One-hundred-and-four motor vehicle victims, who were systematically recruited for the study of Kim et al(1998), were reevaluated through interview and questionnaire after twenty-four months. Clinician Administered PTSD Scale(CAPS), Beck Depression Inventory(BDI), Spiel-berger State Trait Anxiety Inventory(STAI), Impact of Event Scale(IES), questions about socioen-vironmental experiences after accident, and The Ways of Coping Checklist(WCC) were included in follow-up assessment. Of these subjects, 68 victims participated in CAPS interview and only 54 victims finished CAPS Interview, and questionnaire. The subjects with PTSD at initial and follow-up assessment were classified as the chronic PTSD group, subjects who recovered from PTSD at follow-up assessment were classified as the recovered group, and subjects who did not meet criteria for PTSD at initial and follow-up assessment were classified as the non-PTSD group. RESULTS: The prevalence of PTSD in motor vehicle victims was 39.8% in follow-up assessment. Compensation of disabilities, return to previous job and financial difficulty were associated with chronicity and poor psychological adjustment of PTSD. In total group of victims, PTSD symptoms that appeared at initial assessment were improved or disappeared at follow-up assessment. However, avoidance and numbing symptoms significantly increased in chronic PTSD group and "acting or feeling as if event were recurring" and "exaggerated startle response" were not recovered over time in recovered group. Only IES at initial assessment showed significant differences among Non-PTSD, PTSD and recovered group. BDI, STAI-II, active coping and passive coping at follow-up assessment showed significant differences among three groups. IES at initial assessment contributed 18.6% to CAPS variance at follow-up. CONCLUSION: This study showed a high risk of developing PTSD among physically injured victims after motor vehicle accident. Risk factors such as event severity, compensation of disabilities, return to previous job and financial difficulty were identified. High IES score at initial assessment was regarded as major factor affecting chronic PTSD.
Subject(s)
Humans , Emotional Adjustment , Anxiety , Compensation and Redress , Depression , Follow-Up Studies , Incidence , Motor Vehicles , Prevalence , Prospective Studies , Surveys and Questionnaires , Risk Factors , Stress Disorders, Post-TraumaticABSTRACT
With the increasing number of air bag-equipped vehicles, there has been a corresponding increase in the incidence of air bag-associated ocular trauma. We encountered a 38 years old man who sustained corneal damage, hyphema, angle recession, medial wall fracture, and visual damage by choroidal rupture of macula due to an inflated air bag in motor vehicle accident and brief review of related literature is presented.