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1.
Chinese Journal of Traumatology ; (6): 56-58, 2017.
Article Dans Anglais | WPRIM | ID: wpr-330448

Résumé

Neck, being not protected by skeleton, is vulnerable to external trauma and injury which involves blood vessels, trachea, esophagus and other endocrine and nervous system organs. Vascular injuries can not only cause potentially life-threatening hemorrhage but also need profound surgical expertise in management. Development of collateral circulation in neck is well known; however, there is scarcity of literature on the role of collateral formation in neck trauma. Here, we present a unique case of penetrating gunshot injury to neck with right common carotid and right subclavian artery injury with hemorrhagic shock managed with ligation of these vessels as a life-saving procedure. The patient presented with no neurological or motor deficits in immediate postoperative period owing to the collateral circulation between right vertebral artery and right common carotid and right subclavian artery.


Sujets)
Adulte , Humains , Mâle , Lésions traumatiques de l'artère carotide , Imagerie diagnostique , Chirurgie générale , Artère carotide commune , Imagerie diagnostique , Chirurgie générale , Ligature , Traumatismes du cou , Imagerie diagnostique , Chirurgie générale , Artère subclavière , Imagerie diagnostique , Plaies et blessures , Tomodensitométrie , Plaies par arme à feu , Imagerie diagnostique , Chirurgie générale
2.
Chinese Journal of Traumatology ; (6): 122-124, 2017.
Article Dans Anglais | WPRIM | ID: wpr-330443

Résumé

The management of hemodynamically normal patients with retained intra-pericardial foreign body remains a matter of conjecture. The available literature supports non-operative management of such innocuous foreign bodies. We report our experience of a hemodynamically normal patient with a retained intra-pericardial pellet from a firearm injury. He initially received successful non-operative management but developed fatal hemopericardium 21 days after injury. In this paper, we discussed the pitfalls in the management of such injuries in light of the available literature and summarized the clinical experience.


Sujets)
Adulte , Humains , Mâle , Issue fatale , Corps étrangers , Thérapeutique , Lésions traumatiques du coeur , Thérapeutique , Plaies par arme à feu , Thérapeutique
3.
Chinese Journal of Traumatology ; (6): 75-78, 2016.
Article Dans Anglais | WPRIM | ID: wpr-235778

Résumé

<p><b>PURPOSE</b>The epidemiology of pediatric trauma is different in different parts of the world. Some re- searchers suggest falls as the most common mechanism, whereas others report road traffic accidents (RTAs) as the most common cause. The aim of this study is to find out the leading cause of pediatric admissions in Trauma Surgery in New Delhi, India.</p><p><b>METHODS</b>Inpatient data from January 2012 to September 2014 was searched retrospectively in Jai Prakash Narayan Apex Trauma Centre Trauma Registry. All patients aged 18 years or less on index presentation admitted to surgical ward/ICU or later taken transfer by the Department of Trauma Surgery were included. Data were retrieved in predesigned proformas. Information thus compiled was coded in unique alphanumeric codes for each variable and subjected to statistical analysis using SPSS version 21.</p><p><b>RESULTS</b>We had 300 patients over a 33 month period. Among them, 236 (78.6%) were males and 64 (21.3%) females. Overall the predominant cause was RTAs in 132 (43%) patients. On subgroup analysis of up to 12 years age group (n = 147), the most common cause was found to be RTAs again. However, falls showed an incremental upward trend (36.05% in up to 12 age group versus 27% overall), catching up with RTAs (44.89%). Pediatric Trauma Score (PTS) ranged from 0 to 12 with a mean of 8.12 ± 2.022. 223 (74.33%) patients experienced trauma limited to one anatomic region only, whereas 77 (25.66%) patients suffered polytrauma. 288 patients were discharged to home care. Overall, 12 patients expired in the cohort. Median hospital stay was 6 days (range 1-182).</p><p><b>CONCLUSION</b>Pediatric trauma is becoming a cause of increasing concern, especially in the developing countries. The leading cause of admissions in Trauma Surgery is RTAs (43%) as compared to falls from height (27%); however, falls from height are showing an increasing trend as we move to younger age groups. Enhancing road safety alone may not be a lasting solution for prevention of pediatric trauma and local injury patterns must be taken into account when formulating policies to address this unique challenge.</p>


Sujets)
Adolescent , Enfant , Enfant d'âge préscolaire , Femelle , Humains , Mâle , Chutes accidentelles , Mortalité , Accidents de la route , Mortalité , Bases de données factuelles , Pays en voie de développement , Incidence , Inde , Score de gravité des lésions traumatiques , Durée du séjour , Pédiatrie , Enregistrements , Appréciation des risques , Taux de survie , Centres de traumatologie , Plaies et blessures , Diagnostic , Épidémiologie , Chirurgie générale
4.
Chinese Journal of Traumatology ; (6): 333-336, 2016.
Article Dans Anglais | WPRIM | ID: wpr-235714

Résumé

<p><b>PURPOSE</b>Traumatic cardiac injury (TCI) is a challenge for trauma surgeons as it provides a short thera- peutic window and the management is often dictated by the underlying mechanism and hemodynamic status. The current study is to evaluate the factors influencing the outcome of TCI.</p><p><b>METHODS</b>Prospectively maintained database of TCI cases admitted at a Level-1 trauma center from July 2008 to June 2013 was retrospectively analyzed. Hospital records were reviewed and statistical analysis was performed using the SPSS version 15.</p><p><b>RESULTS</b>Out of 21 cases of TCI, 6 (28.6%) had isolated and 15 (71.4%) had associated injuries. Ratio be- tween blunt and penetrating injuries was 2:1 with male preponderance. Mean ISS was 31.95. Thirteen patients (62%) presented with features suggestive of shock. Cardiac tamponade was present in 12 (57%) cases and pericardiocentesis was done in only 6 cases of them. Overall 19 patients underwent surgery. Perioperatively 8 (38.1%) patients developed cardiac arrest and 7 developed cardiac arrhythmia. Overall survival rate was 71.4%. Mortality was related to cardiac arrest (p = 0.014), arrhythmia (p = 0.014), and hemorrhagic shock (p =0.04). The diagnostic accuracy of focused assessment by sonography in trauma (FAST) was 95.24%.</p><p><b>CONCLUSION</b>High index of clinical suspicion based on the mechanism of injury, meticulous examination by FAST and early intervention could improve the overall outcome.</p>


Sujets)
Adulte , Femelle , Humains , Mâle , Lésions traumatiques du coeur , Imagerie diagnostique , Chirurgie générale , Études rétrospectives , Tomodensitométrie
5.
BEAT-Bulletin of Emergency and Trauma. 2016; 4 (4): 250-251
Dans Anglais | IMEMR | ID: emr-186135
6.
Chinese Journal of Traumatology ; (6): 50-53, 2012.
Article Dans Anglais | WPRIM | ID: wpr-334551

Résumé

Thoracic impalement injuries are very rare and the majority of patients do not survive to reach a medical care facility. In this case report, we describe the successful outcome of a case of double thoracic impalement by two steel tors, of which one steel tor had impaled two patients simultaneously. The case report highlights all aspects of managing such rare and complex cases right from prehospital care; extrication process which happened under controlled environment at the trauma centre itself, till the definitive management of the impaled thoracic objects. Thoracic impalement injuries are dramatic and appear very challenging. However presence of mind of the managing team, coordinated team effort and availability of adequate facilities can lead to a successful outcome.


Sujets)
Humains , Blessures du thorax , Plaies pénétrantes
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