RESUMO
Blunt chest trauma is associated with a variety of lethal injuries, many of which are responsible for prehospital mortality. Major intrathoracic vascular injury accounts for a vast majority of these fatal injuries. Patients surviving after main pulmonary artery injury are rare. We present the case of a patient who sustained a main pulmonary artery laceration as a result of a blunt motor vehicle crash. He was diagnosed accurately by computed tomography and underwent successful repair.
Assuntos
Artéria Pulmonar/lesões , Traumatismos Torácicos/complicações , Ferimentos não Penetrantes/complicações , Acidentes de Trânsito , Idoso , Humanos , Masculino , Artéria Pulmonar/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ferimentos e Lesões/diagnóstico por imagemRESUMO
We report a case of a patient with acute aortic thrombosis. A discussion of the reported literature, presentation, surgical management, and natural history follows. This is an interesting addition to a rare vascular condition.
Assuntos
Doenças da Aorta/etiologia , Trombose/complicações , Idoso , Doenças da Aorta/diagnóstico , Doenças da Aorta/cirurgia , Humanos , Masculino , Trombose/diagnóstico , Trombose/cirurgiaRESUMO
The use of antibiotics for patients undergoing tube thoracostomy was determined to be highly variable based on a study conducted at a national meeting of surgeons. A meta-analysis of six randomized studies previously reported was performed. The analysis was carried out using the Confidence Profile Method software FAST*PRO. The meta-analysis was structured using dichotomous outcomes of infectious chest processes (empyema, effusion, pneumonia, wound infection, tracheitis, etc.) versus no infectious chest process in patients with and without antibiotics. The effect measures calculated included actual difference in probabilities, relative risk, percent differences in probabilities, and odds ratio. The results of this meta-analysis suggest that antibiotics should be used in patients undergoing tube thoracostomy. Antibiotic selection should maximize therapy for Staph. aureus. The implementation of this practice guideline will require the co-operation of multiple specialty oriented physicians and surgeons.
