scholarly journals Perioperative and Intensive Care Management of Pediatric Tracheal Tear

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Sanjay M. Bhananker ◽  
Ramesh Ramaiah
Keyword(s):  
High Speed ◽  
Motor Vehicle ◽  
Rare Condition ◽  
Ct Scanner ◽  
Tracheal Injury ◽  
Vehicle Collision ◽  
Life Threatening ◽  
Tracheal Tear ◽  
Brainstem Herniation ◽  
Imminent Threat

Management of tracheal tears can prove to be challenging in the perioperative setting. This is a rare condition that can be life threatening. Here, we present a case of seven-year-old boy involved in a high-speed motor vehicle collision. The child sustained multiple injuries including a near fatal head injury, multiple facial fractures, and a tracheal injury associated with pneumomediastinum. Due to the imminent threat of brainstem herniation while being imaged in the CT scanner, the patient underwent an emergent craniotomy to evacuate his evolving intracranial bleed. Imaging prior to the craniectomy suggested a possible tracheal injury, given the extensive pneumomediastinum. However, initial perioperative ventilation was without any difficulty. After stabilization of intracranial pressure (ICP) and hemodynamics, on hospital day 4, the patient returned to the operating room to diagnose and repair his tracheobronchial injury. This is a unique polytrauma case in which a tracheal tear was managed in the midst of other life-threatening injuries.

scholarly journals Delayed Presentation of Traumatic Pericardial Rupture: Diagnostic and Surgical Considerations for Treatment

2018 ◽  
Vol 21 (4) ◽  
pp. E254-E256 ◽  
Author(s):  
Amy G Fiedler ◽  
Puja Banka ◽  
Katherine Zaleski ◽  
Michael C Fahey ◽  
Roger E Breitbart ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Delayed Diagnosis ◽  
Surgical Techniques ◽  
Rare Event ◽  
Rare Condition ◽  
Delayed Presentation ◽  
Cardiac Herniation ◽  
Vehicle Collision ◽  
Pericardial Rupture ◽  
Thoracic And Abdominal

Traumatic pericardial rupture is a rare event with high mortality. We present the case of a 15-year-old boy who sustained thoracic and abdominal trauma secondary to motor vehicle collision, with a delayed diagnosis of traumatic pericardial rupture with cardiac herniation. Out of concern for torsion and hemodynamic collapse, surgical repair was advised. We have developed a novel surgical approach to this rare condition, utilizing a combination of thoracoscopic and open surgical techniques. The guiding principles of our repair include the utilization of fenestrated pieces of bovine pericardium to create a tension free repair, minimizing the likelihood of pericardial effusion, and returning the cardiac mass to normal anatomic position.

Diffuse Axonal “Shear” Injury in an 18-year-old Man Following a High-speed Motor Vehicle Collision

2005 ◽  
Vol 31 (1) ◽  
pp. 112-114
Author(s):  
Kelly A. Thompson-Brazill ◽  
Claudia E. Goettler ◽  
Michael F. Rotondo
Keyword(s):  
High Speed ◽  
Motor Vehicle ◽  
Motor Vehicle Collision ◽  
Vehicle Collision ◽  
Shear Injury

scholarly journals Case Report: Delayed Presentation of Bowel Obstruction Caused by Blunt Abdominal Trauma

2020 ◽  
Vol 4 (4) ◽  
pp. 620-622
Author(s):  
Nicholas George ◽  
Charles Baldi ◽  
James Tonascia ◽  
Siamak Moayedi
Keyword(s):  
Case Report ◽  
Bowel Obstruction ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
High Speed ◽  
Bowel Wall ◽  
Motor Vehicle ◽  
Delayed Presentation ◽  
Vehicle Collision ◽  
Post Traumatic

Introduction: Bowel obstruction is a rare but well reported complication of blunt abdominal trauma (BAT). Obstruction is most often seen acutely caused by bowel wall hematomas and chronically as a result of post-traumatic strictures. Here, we present a novel case of BAT causing a subacute obstructing bowel wall hematoma. Case Report: A healthy, 32-year-old male presented to our emergency department with three days of nausea and vomiting. Chart review revealed he had been seen two weeks prior after a high-speed motor vehicle collision. During that initial visit, the patient had a benign abdominal exam and was discharged without imaging. On this return visit, the patient was found to have a large, obstructing colonic hematoma. Conclusion: Because emergency physicians care for patients in both the acute and subacute phases of trauma, clinicians should recognize the more subtle sequelae of BAT.

scholarly journals Global Cerebral Anoxia

2002 ◽  
Vol 29 (1) ◽  
pp. 88-90 ◽  
Author(s):  
Jean-Wen Chan ◽  
Kathleen E. Bell
Keyword(s):  
Glasgow Coma Scale ◽  
Glasgow Coma Scale Score ◽  
High Speed ◽  
Motor Vehicle ◽  
Cardiopulmonary Arrest ◽  
Cervical Cord ◽  
Cerebral Anoxia ◽  
Vehicle Collision ◽  
Cord Injury ◽  
Cervical Cord Injury

A 57-year-old, previously healthy tourist sustained closedhead trauma during a high-speed motor vehicle collision. She was found unconscious at the scene with a Glasgow coma scale score of 3. She suffered a multitude of injuries including frontal scalp lacerations and cervical cord injury. Upon arrival at the hospital, she suffered cardiopulmonary arrest of up to 12 minutes without a perfusing rhythm and was intubated.

A Case of Dual Thoracoabdominal Impalement in Vehicular Trauma

2008 ◽  
Vol 74 (8) ◽  
pp. 757-760
Author(s):  
Robert D. Winfield ◽  
Alexander G. Parr ◽  
Darwin N. Ang ◽  
Tomas D. Martin ◽  
Mike K. Chen ◽  
...  
Keyword(s):  
High Speed ◽  
Motor Vehicle ◽  
Multidisciplinary Teams ◽  
Institutional Review Board Approval ◽  
Vehicle Collision ◽  
Institutional Review ◽  
Rapid Action ◽  
Key Points ◽  
Austere Environment ◽  
Dual Case

Impalement injuries are relatively uncommon during vehicular trauma. We present a dual case report of patients sustaining simultaneous impalement injuries during a high-speed motor vehicle collision in a rural (austere) environment. After Institutional Review Board approval, we performed a review of the patients’ medical records. Two young men were traveling in an automobile at high speed when the driver lost control of the vehicle, causing it to strike a wooden fence. Portions of the fence were dislodged, penetrated the windshield, and impaled both the driver and passenger. Both patients were extricated rapidly and transported to our trauma center. Multidisciplinary teams consisting of trauma, thoracic, plastic, and hepatobiliary surgeons addressed the injuries of both patients. Both survived their injuries and have since returned to their homes. This case of dual impalements highlights three key points: first, the principles of management of thoracoabdominal impalement injuries; second, the importance of rapid action of first responders in complex traumas; and finally, the value of using a multidisciplinary surgical team in complicated trauma cases.

scholarly journals Motor Vehicle Collision Patient with Simultaneous Duodenal Transection and Thoracic Aorta Injury: A Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Charlie Chen ◽  
Kevin Schuster ◽  
Bishwajit Bhattacharya
Keyword(s):  
Thoracic Aorta ◽  
High Speed ◽  
Motor Vehicle ◽  
Motor Vehicle Collision ◽  
Review Of The Literature ◽  
The Past ◽  
Vehicle Collision ◽  
Present Complex ◽  
Surgical Teams ◽  
Aorta Injury

Blunt polytrauma can present complex management decisions. Here we report the case of a 31-year-old male involved in a high speed motor vehicle collision resulting in both duodenal and thoracic aorta injury that was managed collaboratively between the trauma, vascular, and cardiothoracic surgical teams. The patient went on to a full recovery. We also review the management of such injuries which has evolved over the past two decades resulting in less morbidity and mortality.

scholarly journals A Novel Treatment for Massive Hemorrhage after Maternal Trauma in Pregnancy

2019 ◽  
Vol 09 (01) ◽  
pp. e27-e29 ◽  
Author(s):  
Maritza Gonzalez ◽  
Ruth Wei ◽  
Kenneth Hatch ◽  
Lynn Gries ◽  
Meghan Hill
Keyword(s):  
Motor Vehicle ◽  
Massive Hemorrhage ◽  
Maternal Trauma ◽  
External Compression ◽  
Novel Treatment ◽  
Vehicle Collision ◽  
Life Threatening ◽  
Trauma In Pregnancy ◽  
In Pregnancy ◽  
Bakri Balloon

Background Trauma in pregnancy can lead to life-threatening hemorrhage. Conventional treatments of hemorrhage include medical and surgical management. However, if these measures fail uterine compression is an option to control bleeding. We present a case where this management was employed. Case A patient presented at 36 weeks of gestation with multiple injuries after a motor vehicle collision and experienced disseminated intravascular coagulation (DIC). The use of a Bakri balloon in combination with external compression with Coban, a sterile self-adherent bandage, after delivery temporized her bleeding and allowed her to become stable for further management. Conclusion When other measures fail and a hysterectomy is considered unsafe, the combination of internal and external uterine compression is an option.

Case Exercise: Biomechanics in Rearend Motor Vehicle Collisions

2007 ◽  
Vol 12 (3) ◽  
pp. 4-7
Author(s):  
Charles N. Brooks ◽  
Christopher R. Brigham
Keyword(s):  
Motor Vehicle ◽  
Body Position ◽  
Motor Vehicle Collisions ◽  
Time Curve ◽  
Vehicle Collisions ◽  
Need For Treatment ◽  
Multiple Factors ◽  
Bodily Injury ◽  
Vehicle Collision ◽  
Physical Findings

Abstract Multiple factors determine the likelihood, type, and severity of bodily injury following a motor vehicle collision and, in turn, influence the need for treatment, extent of disability, and likelihood of permanent impairment. Among the most important factors is the change in velocity due to an impact (Δv). Other factors include the individual's strength and elasticity, body position at the time of impact, awareness of the impending impact (ie, opportunity to brace, guard, or contract muscles before an impact), and effects of braking. Because Δv is the area under the acceleration vs time curve, it combines force and duration and is a useful way to quantify impact severity. The article includes a table showing the results of a literature review that concluded, “the consensus of human subject research conducted to date is that a single exposure to a rear-end impact with a Δv of 5 mph or less is unlikely to result in injury” in most healthy, restrained occupants. Because velocity incorporates direction as well as speed, a vehicular occupant is less likely to be injured in a rear impact than when struck from the side. Evaluators must consider multiple factors, including the occupant's pre-existing physical and psychosocial status, the mechanism and magnitude of the collision, and a variety of biomechanical variables. Recommendations based solely on patient history and physical findings (and, perhaps, imaging studies) may be ill-informed.

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