ABSTRACT
Over a 3 year period all severely injured blunt trauma patients who were investigated with abdominal ultrasound examinations (AUS) or diagnostic peritoneal lavage (DPL) to exclude intra-abdominal injury were evaluated. The ultrasound examinations were performed by radiologists in 220 severely injured patients (20 of whom also had DPL). The overall sensitivity and specificity of abdominal ultrasound were 82.7% and 99.5%, respectively. The sensitivity increased to 89.1% by repeat scanning. In comparison, 72 DPLs were performed in severely injured patients; the overall sensitivity and specificity of DPL were 82.8% and 97.2%, respectively. DPL resulted in more non-therapeutic laparotomies, 9/25 (36%) compared with 3/23 (13%) with AUS. Abdominal ultrasound is now the first line investigation at this centre for evaluation of possible intra-abdominal injury in injured patients.
Subject(s)
Abdominal Injuries/diagnosis , Wounds, Nonpenetrating/complications , Abdominal Injuries/diagnostic imaging , Humans , Injury Severity Score , Peritoneal Lavage , Prospective Studies , Sensitivity and Specificity , Ultrasonography , Wounds, Nonpenetrating/diagnostic imagingABSTRACT
An outbreak of pharyngeal and limb paresis involving four horses and nine ponies in the south east of England is described. Nine of the animals died or were destroyed on humane grounds. The clinical features suggested a diagnosis of botulism and mouse innoculation tests confirmed the presence of type B toxin in the serum of one case. All animals were fed big bale silage. It is describe how, in plastic wrapped silage manufacture, conditions of fermentation may be inadequate to prevent the growth of Clostridium botulism. Examination of a sample of silage fed to the affected horses suggested that this was probably the source of the toxin.
