scholarly journals Early Identification of Traumatic Durotomy Associated with Atlantooccipital Dislocation May Prevent Retropharyngeal Pseudomeningocele Development

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Robert S. Qiu ◽  
Mina G. Safain ◽  
Max Shutran ◽  
Alejandra M. Hernandez ◽  
Steven W. Hwang ◽  
...  

Atlantooccipital dislocation can be complicated by a traumatic durotomy that may lead to the rare development of a retropharyngeal pseudomeningocele. To our knowledge this has been reported only five times previously. We present the case of a 60-year-old man involved in a motor vehicle accident who suffered an atlantooccipital dislocation and C5-C6 three-column injury. A unique MRI image of a defect in the ventral dura posterior to C2 was appreciated. He underwent occiput to T2 internal fixation and arthrodesis. During surgery, CSF egress was seen caudal to the right C2 nerve root. A DuraMatrix onlay patch reinforced with DuraSeal was placed to stop the CSF leak. A lumbar subarachnoid drain was also placed. The patient made a satisfactory recovery with residual mild weakness of his right upper extremity. In this report, we demonstrate that careful MRI review can reveal a ventral durotomy in a traumatic atlantooccipital dislocation and, if discovered, effective treatment including a lumbar subarachnoid drain for CSF diversion may prevent progression to a retropharyngeal pseudomeningocele. The literature on this rare presentation and associated durotomy is provided.

2017 ◽  
Vol 13 (1) ◽  
Author(s):  
Dario Giambelluca ◽  
Dario Picone ◽  
Natalino Carmelo Pennisi ◽  
Bruno Luciani ◽  
Giuseppe Lo Re ◽  
...  

Gastric rupture following blunt abdominal trauma is a rare presentation with a reported incidence of 0.02-1.7% in current literature. Traumatic gastric rupture is usually associated with other visceral injuries, such as splenic lesions and fractures. Prompt diagnosis and early intervention reduce mortality and morbidity. History of a recent meal has been implicated in traumatic gastric rupture. 2 We report a case of blunt abdominal trauma with an isolated gastric rupture after a motor vehicle accident, managed successfully without any post-operative morbidity and mortality.


Author(s):  
Scott Kimbrough

Probability analysis is the key to extracting the maximum information from the evidence surrounding a motor vehicle accident. Moreover, it gives essential perspective to the answers drawn from the evidence, by conveying the uncertainty about the answers. In this paper, probability methods are used to analyze a typical intersection type collision between two vehicles. It is a situation in which one of the vehicles pulls out from a stop sign into the path of the other vehicle, which had the right of way. The vehicle that pulls out into the path of the oncoming vehicle precipitates the accident, but the driver of the oncoming vehicle may have contributed to the accident by traveling at excessive speed and or by being inattentive.


2015 ◽  
Vol 100 (3) ◽  
pp. 444-449 ◽  
Author(s):  
Vasileios Kalles ◽  
Maria Dasiou ◽  
Georgia Doga ◽  
Ioannis Papapanagiotou ◽  
Evangelos A Konstantinou ◽  
...  

Intercostal hernias are rare, and usually occur following injuries of the thoracic wall. The scope of this report is to present a case of a 53-year-old obese patient that developed a transdiaphragmatic intercostal hernia. The patient presented with a palpable, sizeable, reducible mass in the right lateral thoracic wall, with evident bowel sounds in the area, 6 months after a motor-vehicle accident. On computed tomography (CT), the hernia sac contained part of the liver and part of the ascending colon. A surgical repair of the defect was performed, using a prosthetic patch. The patient's postoperative course was uneventful and she remains recurrence free at 12 months after surgery. Intercostal hernias should be suspected following high-impact injuries of the thoracic wall, and CT scans will facilitate the diagnosis of intercostal hernia. We consider the surgical repair of the defect, with placement of a prosthetic mesh, as the treatment of choice to ensure a favorable outcome.


2010 ◽  
Vol 27 (5) ◽  
pp. 587-589 ◽  
Author(s):  
Ming C. Hsiung ◽  
Yi Cheng Chang ◽  
Jeng Wei ◽  
Gong-You Lan ◽  
Kuo Chen Lee ◽  
...  

Author(s):  
Chidananda Ramappa Devasamudra ◽  
Niveditha J Sagar

ABSTRACT Background A 28-year-old lady presented with cheek hematoma on the right side after the self-fall. This patient had severe facial disfigurement due to diffuse swelling of cheek, discoloration of facial skin and sclera. The facial expressions were also compromised. Materials and methods Detailed history taken, examination done to rule out motor vehicle accident (MVA), domestic violence and central nervous system (CNS) involvement. Computed tomography scan was done to know the extent of hematoma and to rule out the oromaxillofacial bone fractures. Incision and drainage was done to remove the blood clot from the buccal space. Incision was given in the buccal mucosa to avoid external scar. Result Swelling was completely reduced on 3rd postoperative day. Facial movements and expressions were regained. Conclusion Intraoral Incision and drainage is the treatment of choice for cheek hematoma to reduce the size of the swelling and avoid external scar. How to cite this article Sagar NJ, Devasamudra CR. Cheek Hematoma: A Rare Presentation. Panam J Trauma Crit Care Emerg Surg 2015;4(1):39-42.


2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Mariam Meddeb ◽  
Robert D. Chow ◽  
Randolph Whipps ◽  
Reyaz Haque

Uterine leiomyomas are the most common gynecological tumors in premenopausal women. While the lung is the most common extrauterine organ afflicted, benign metastasizing leiomyomas (BML) of the heart are rarities. We report an incidental finding of a cardiac mass in a 36-year-old woman who presented to the Emergency Department after a motor vehicle accident. CT scan of the chest revealed 2 well-circumscribed pulmonary nodules and a filling defect in the right ventricle. Echocardiogram showed a 4 cm mass attached to the right ventricular (RV) septum. The cardiac tumor was resected and showed benign histologic features. Immunohistochemical staining was positive for smooth muscle α-actin and desmin, as well as estrogen and progesterone receptors, consistent with the diagnosis of uterine leiomyoma.


Author(s):  
Christine U. Lee ◽  
James F. Glockner

22-year-old woman with a history of diabetes mellitus, hyperlipidemia, and polycystic ovarian syndrome; she was involved in a motor vehicle accident, and abdominal CT demonstrated multiple hepatic masses Axial fat-suppressed FSE T2-weighted image (Figure 1.16.1) demonstrates at least 2 hyperintense masses in the periphery of the right hepatic lobe. Diffusion-weighted image (b=600 s/mm...


2006 ◽  
Vol 72 (2) ◽  
pp. 116-117
Author(s):  
Sharmila Dissanaike ◽  
John A. Griswold ◽  
Ari Halldorsson ◽  
Eldo E. Frezza

We present a case of a patient sustaining an isolated injury to the right main branch of the cysterna chyli due to a high-speed motor vehicle accident. A 42-year-old man presented after a high-speed collision. CT revealed a collection of hypodense fluid in the gallbladder fossa, which was the clue to take him to the OR. We proceeded to laparoscopic exploration, and based on the milky white color of the fluid, identified a chyle leak. In an open fashion, the retroperitoneum was explored and the injury was identified as disruption of the right lumbar branch entering the cisterna chyli, and this was ligated with silk ties. Chyle duct injury secondary to blunt trauma is a rare finding. The use of CT imaging can identify this injury. Laparoscopy can confirm the injury. Open ligation of the injured duct is the best treatment.


2005 ◽  
Vol 2 (3) ◽  
pp. 381-385 ◽  
Author(s):  
Iman Feiz-Erfan ◽  
L. Fernando Gonzalez ◽  
Curtis A. Dickman

✓ The authors describe a new technique of internal atlantooccipital screw fixation involving posterior wiring and fusion for the treatment of traumatic atlantooccipital dislocation, which was performed in a 17-year-old male patient involved in a motor vehicle accident and who suffered from atlantooccipital dislocation without neurological injury. At the 6-month follow-up examination, the patient was neurologically intact with a solid occipitocervical fusion and full range of motion of the neck.


2018 ◽  
Vol 24 (1) ◽  
pp. 57-59
Author(s):  
Caggiari Gianfilippo ◽  
Mosele Giulia Raffaella ◽  
Puddu Leonardo ◽  
Spiga Mauro ◽  
Doria Carlo

Fracture-dislocation of the humeral head with intrathoracic migration is extremely rare. In our study we describe the case of a 23-year-old man who was admitted to the emergency clinic of our hospital, after being injured in a high-speed motor vehicle accident. The patient presented in a state of hemorrhagic shock and severe respiratory disease. Chest radiography showed fracture of the right humeral head and the presence of a round radio-density area resting on the diaphragm right hemithorax. The total body computed tomography scan revealed a right pneumothorax related to the presence in the chest cavity of the fractured humeral head, longitudinal fracture of the sacrum, and diastasis of the symphysis pubis. After an initial hemodynamic stabilization the patient underwent surgical excision of the humeral head and its replanting. It is important after airway management and the use of diagnostic imaging, the treatment of any injuries associated with the trauma.


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