ABSTRACT
A 3-month-old girl presented to the emergency department with a clinical picture compatible with sepsis. When peripheral IV cannulation could not be attained, intraosseous (IO) access was attempted unsuccessfully in both tibias as well as in the right femur. The child was subsequently treated for S pneumoniae meningitis. Three days after discharge and 14 days after initial presentation, the family noticed swelling of the child's right leg. Radiographs revealed healing fractures of both proximal tibias. This case represents a previously unreported complication of intraosseous infusions and underscores the need for the use of proper technique and equipment.
Subject(s)
Bone and Bones , Drug Administration Routes , Iatrogenic Disease , Tibial Fractures/etiology , Female , Humans , Infant , Needles , Radiography , Tibial Fractures/diagnostic imagingABSTRACT
A prospective study was designed to evaluate the reliability of excretory urography (EU) in excluding renal damage in patients with blunt abdominal trauma, using contrast-enhanced computed tomography (CECT) as the "gold standard" of diagnostic studies. Sixty patients with indications for genitourinary evaluation and with normal EU underwent CECT. Five renal injuries were demonstrated by CECT in patients with negative EU: one contusion, one subcapsular hematoma, two perirenal hematomas, and one renal laceration. All of these lesions resolved with conservative patient management. Thus, the CECT findings did not alter treatment in these five patients.
