An unusual case of four iliac veins injured by gunshot: case report and review of the literature.

Multiple injuries of iliac veins are uncommon and frequently fatal. An unusual case in which there were injuries of the four iliac veins by gunshot is described. Prompt control of hemorrhage is required. Because our patient was in unstable condition, ligation of the four iliac veins was performed and the abdomen was packed. After a complicated course, the patient was discharged after 40 days in good condition. Although venous repair is often recommended, ligation in extensive injuries may be necessary, and is usually well tolerated in young, previously healthy individuals like our patient.

[Simultaneous injury of 4 iliac veins by firearm: report of a case and review of the literature]. / Lesão simultânea das quatro veias ilíacas por arma de fogo: relato de caso e revisão bibliográfica.

Iliac vessel injuries constitute approximately 10 percent of all vascular traumatic lesions. The high mortality rate is due to the massive exsanguination and the high frequency of associated injuries. Iliac vein injury occurs either isolated or in association with the arterial lesion. Multiple injuries of iliac veins are uncommon and frequently fatal. An unusual case, in which there were injuries of the four iliac veins by gunshot is described. A review of literature of this condition and a discussion about the diagnosis, treatment and factors affecting mortality rate is presented. No other such case has been found reported.

[Traumatic right diaphragmatic hernia: report of a case and review of the diagnostic methods]. / Hernia diafragmática traumática direita: relato de caso e revisão demétodos diagnósticos.

Rupture of the right hemidiaphragm from blunt trauma is uncommon. Better management and more rapid transportation of victims has increased the frequency with which patients sustaining this injury are arriving at the emergency room alive. A case of right-sided diaphragmatic hernia from blunt trauma in a 36-year-old man is reported. Diagnosis was established by chest x-ray, CT scan and digital exploration after unsuccessful thoracoscopy. The methods used for diagnosis of this condition are analysed.

[Tissue necrosis: a side effect of sodium diclofenac: report of cases and discussion of the physiopathology]. / Necrose tecidual: efeito colateral do diclofenaco de sódio, relato de casos e discussão da fisiopatologia.

Diclofenac sodium is a non-steroidal anti-inflammatory widely used drug both in the treatment of the rheumatic diseases and as analgesic. The fact that is a potent analgesic spread its use to almost all fields in medicine, increasing the reports of adverse effects associated with it. The main complications reported are gastrointestinal, dermatological and of the central nervous system. The authors present seven cases that developed tissue necrosis as a result of the intramuscular injection of diclofenac sodium. Because of the low incidence or this adverse effect, a review is carried out and the physiopathologic mechanisms likely to be involved are discussed. Our aim is to warn against the indiscriminate intramuscular use of this drug.