High-pressure injection injuries to the hand.

High-pressure injection injury hides the true extent of the lesions behind an apparent small and harmless puncture of the finger or the hand. Through clinical description, we wish to point out the need for prompt treatment to avoid mutilating and function-threatening complications. We wish to outline the role of the emergency physician who must be aware of the incidence of high-pressure injection injury and become accustomed to early referral to a surgeon, experienced in extensive surgical exploration, removal of foreign bodies, and rehabilitation. The open-wound technique gives the best results. We also point out that failure to refer may become an increasing focus of negligence claims.

[Cholestatic hepatitis and amoxicillin-clavulanic acid combination. Personnel case report and literature review]. / Hépatite cholostatique et association amoxicilline-acide clavulanique. Observation personnelle et revue de la littérature.

The association amoxicillin-clavulanic acid is a widely used medication. Only about 15 cases of cholestatic hepatitis were reported in Belgium between 1990 and 1993; about 100 cases have been reported to the pharmaceutical company. This effect is severe but reversible. The injury is probably idiosyncratic or immunologically based. Age, sex and treatment duration are as many agents of risk. The diagnosis is undertaken on basis of clinical examination, chronological study, biological evolution and histology.