ABSTRACT
INTRODUCTION: the clavicle is one of the most commonly fractured bones, accounting for up to 4-10% of all adult's fractures. These fractures are comparatively easy to manage and typically heal with routine immobilisation. CASE REPORT: a 28 year old man had direct driving trauma to the left shoulder and reported a displaced fracture of the third lateral of left clavicle and an apical pneumothorax. The pneumothorax was treated by the insertion of a chest drain under local anaesthesia. The chest drain was removed 12 days after the injury and the patient was transferred in Traumatology for specific therapy. RESULT: 6 months after the accident, the clavicular fracture had united and the chest radiograph and CT were normal. DISCUSSION: most clavicular fractures result from a fall or a trauma on ipsilateral shoulder. However, the incidence of complications associated with isolated clavicle fracture, including vascular, brachial plexus, and penumothorax, are low but potentially serious. CONCLUSION: careful history and physical examination with particular attention to the neurovascular and chest examination are vital. Close inspection of the radiographs for such potential complication are mandatory in all clavicular fractures and cannot be overstated. From the analysis of international literature, we can affirm that thoracostomy and immobilization are effective to heal pneumothorax and clavicle fracture.
Subject(s)
Clavicle/injuries , Fractures, Bone/complications , Pneumothorax/etiology , Adult , Humans , Male , Pneumothorax/diagnostic imaging , RadiographyABSTRACT
OBJECTIVE: The authors report their experience about the endoscopic (ERCP) treatment of multiple choledocholithiasis. DESIGN: Report of 5 cases; evaluation of mortality and effectiveness of the treatment. SETTING: Operative Unit of General and Thoracic Surgery, Department of Surgical, Anatomical and Oncological Disciplines. Policlinico, University of Palermo. INTERVENTIONS: ERCP + ES + clearance of bile duct stones in all 5 patients. RESULTS: 100% successful. CONCLUSION: ERCP is choice treatment of multiple choledocholithiasis, only in well experienced teams.
