RESUMO
We describe a case of penetrating spinal cord injuries in an 20-year-old man after stab wound attack. The outcome was complicated with subarachnoid fistula and meningitis. The diagnosis and management of these complications are discussed.
Assuntos
Fístula/etiologia , Meningites Bacterianas/etiologia , Doenças Pleurais/etiologia , Infecções por Pseudomonas/etiologia , Traumatismos da Medula Espinal/complicações , Espaço Subaracnóideo , Ferimentos Perfurantes , Adulto , Amicacina/uso terapêutico , Quimioterapia Combinada/uso terapêutico , Humanos , Imipenem/uso terapêutico , Masculino , Meningites Bacterianas/tratamento farmacológico , Pleura , Infecções por Pseudomonas/tratamento farmacológico , Pseudomonas aeruginosa , Radiografia , Traumatismos da Medula Espinal/diagnóstico por imagemRESUMO
We report a case of a 23-year-old patient admitted for a right femur fracture resulting from a traffic accident. An intra-alveolar haemorrhage occurred 48 hours later, with asphyxia anaemia, haematic bronchial aspirations, and bilateral alveolar opacities at chest X-ray. This symptomatology was associated with fever, sub-conjunctival petechiae, major hypocholesterolemia, deterioration of renal function, and cholestasis. All these features suggested a fat embolism. Other possible aetiologies were discarded because of normal cardiovascular and immunologic systems and absence of infection. The outcome under symptomatic treatment was satisfactory within 15 days. The occurrence of intra-alveolar haemorrhage in post-traumatic fat embolism is a rare event caused by pulmonary capillary obstruction by fat emboli.
Assuntos
Embolia Gordurosa/etiologia , Fraturas do Fêmur/complicações , Hemorragia/etiologia , Pneumopatias/etiologia , Acidentes de Trânsito , Adulto , Asfixia/etiologia , Humanos , Pneumopatias/diagnóstico por imagem , Masculino , Alvéolos Pulmonares , RadiografiaAssuntos
Transfusão de Sangue/estatística & dados numéricos , Transfusão de Sangue/normas , Cuidados Críticos , Cuidados Pós-Operatórios , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Prescrições , Estudos Prospectivos , Garantia da Qualidade dos Cuidados de SaúdeRESUMO
Acute renal failure caused by obstruction by the gravid uterus is a rare complication of pregnancy. We report a case of obstructive acute renal failure in a patient at 28 weeks of gestation. Serum creatinine was 65 mg/l. Ultrasound examination showed a solitary right kidney. The course was marked by premature delivery. Renal function spontaneously returned to normal. This case suggests that acute obstructive uropathy should be considered to be a physiological phenomenon, especially on the right side.
