Bladder Injury From Penetrating Trauma of the Inner Thigh.

This is a unique case of bladder injury from a penetrating upper leg wound. The patient's initial presentation did not suggest genitourinary injury, however the patient had a relatively late episode of gross hematuria that prompted further investigation. Based on findings of bladder laceration, the patient was managed conservatively and did well. To our knowledge an injury with this particular trajectory and mechanism has not been described previously in the literature. It stands as a reminder that genitourinary trauma can have many points of origin and that a high index of suspicion is necessary during evaluation of these patients.

Incision and drainage followed by mattress suture repair of auricular hematoma.

OBJECTIVE: Auricular hematoma is a condition requiring early and effective management to prevent pathogenesis of the unsightly cauliflower ear. The objective of this study is to review cases of auricular hematoma and present incision and drainage followed by through-and-through whip-type absorbable mattress sutures without bolsters as an effective treatment. STUDY DESIGN: Retrospective chart review of auricular hematoma cases. METHODS: A 5-year retrospective evaluation of auricular hematomas presenting to an otolaryngology group was performed. Patients' charts were reviewed and data regarding the treatment and follow-up of auricular hematomas were assembled and analyzed. RESULTS: Twenty-two patients were found to present with auricular hematoma. One patient was lost to follow-up. Twenty-eight treatments were performed on 23 ears. Seven hematomas were treated with needle aspiration, two were treated with incision and drainage with iodoform wick placement, and 19 were treated with incision and drainage followed by absorbable mattress sutures. There were five hematoma reaccumulations requiring an additional procedure after treatment by an otolaryngologist. Three followed needle drainage; one followed incision and drainage with wick placement, and one followed incision and drainage with absorbable mattress sutures. CONCLUSION: Incision and drainage followed by through-and-through absorbable mattress sutures appears to be a superior method of treatment with rare reaccumulation of hematoma. This method of treatment was shown to be simple and well tolerated, and it had few complications.