An unusual case of penetrating head injury in a child.

Penetrating head injuries can be the result of numerous intentional or unintentional events, including missile wounds, stab wounds, and motor vehicle or occupational accidents (nails, screw-drivers). Penetrating head injuries in children constitute only a small part of the total number of traumatic head injuries seen in casualty. We report a case of neuro-trauma who was operated in our institution. Patient, 4 years male presented in casualty on 15/01/09 with a iron rod penetrating into the skull.

A rare case of desmoid tumor of thigh.

Extraabdominal desmoid tumor is a locally aggressive tumor despite being histologically benign. To avoid local recurrence, it is important to preoperatively detect the exact localization and extension of the infiltrating or disseminating lesion in this tumor. We report a case of recurrent extraabdominal desmoid tumor, which arose in the posterior thigh region. A 68 yrs old male presented with thigh swelling since past 22 years over posterior aspect of thigh increasing in size over the past 2years. The swelling was extending over the medial and anterior aspect of thigh. On investigation he was found to be case of desmoid tumor of thigh.

Hepatic trauma management and outcome; Our experience.

BACKGROUND: Injuries to the liver have been reported in 35-45% of patients with significant blunt abdominal trauma. Since the introduction of ultrasonography and computerized tomography in the evaluation of these patients, there has been an increase in number of hepatic injuries diagnosed that previously would not have been apparent. AIMS AND OBJECTIVES: The purpose of this study was to determine the epidemiology and pattern of isolated liver injury, significant factors related to management and outcome. MATERIAL AND METHOD: A retrospective study of 50 cases of isolated Hepatic trauma admitted and managed over span of last three years (June 2006-June 2009) at MGM Medical College, Navi Mumbai. OBSERVATION: Out of 50 Patients of isolated liver injury, 36 (72%) were managed conservatively. 14(28%) Patients with refractory hypotension and hemoperitoneum were operated in emergency. The mortality of 3 (6%) cases was related to massive bleeding from liver parenchyma. CONCLUSION: The line of management of isolated liver trauma is primarily guided by the haemodynamic status of the patient at the time of presentation in emergency department and findings on ultrasonography [FAST] and computerized tomography. There is significant association of line of management with volume of hemoperitoneum and number of blood transfusion.

Bladder injuries frequently missed in polytrauma patients.

Bladder injuries are very common in patients who have had road traffic accidents. The method of diagnosis and management of such injuries is well established and accepted. However, trauma to the bladder can be associated with other life-threatening injuries which are frequently missed, and often diagnosed during laparotomy for other reasons. The aim of this study was to diagnose bladder injury in polytrauma patients as early as possible, taking into consideration the fact that these patients are hemodynamically unstable and require rapid evaluation and management. In order to achieve our objective, we used bedside sonography with retrograde instillation of normal saline to diagnose bladder injury in addition to use of the conventional retrograde cystogram.