scholarly journals Blunt Traumatic Retropharyngeal Hematoma with Respiratory Symptoms: A Systematic Review of Reported Cases

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Yu-Ling Tsao ◽  
Chien-Chin Hsu ◽  
Kuo-Tai Chen
Keyword(s):  
Blunt Trauma ◽  
Respiratory Symptoms ◽  
Geriatric Patients ◽  
Life Support ◽  
Spinal Injury ◽  
Case Reports ◽  
Transarterial Embolization ◽  
Minor Trauma ◽  
Long Term Outcome ◽  
Retropharyngeal Hematoma

Background. In patients with blunt trauma, particularly geriatric patients and those with minor trauma, an insidious retropharyngeal hematoma (RH) may deteriorate and have lethal consequences. We review the relevant literature to elucidate the clinical characteristics, treatment, complications, and outcomes of blunt traumatic RH with respiratory symptoms. Data Resources. We reviewed 57 case reports and added one case from our hospital for data analysis. A total of 68 cases were included in this review. Results. The ages of patients ranged from 13 to 94 years, and geriatric patients (age >66 years) constituted 61.2% of the reviewed patients. Falls (54.4%) and traffic accidents (35.3%) were the major trauma mechanisms. Most patients’ symptoms developed within 24 hours of blunt trauma (95.2%), and 73.5% of patients with RH had at least one associated injury. Many patients underwent conservative treatment for RH (63.2%). Surgical treatment (23.5%) and transarterial embolization (8.8%) were used to control retropharyngeal hemorrhage. Twelve patients died; RH and cervical spinal injury were the direct causes of death in 5 patients, whereas the other 7 patients died because of cardiac, pulmonary, or gastrointestinal causes or withdrawal of life support. Conclusions. Geriatric patients constituted the largest proportion of patients with RH, and minor trauma was adequate to result in RH in elderly people. The cornerstone of RH management is airway management. Surgery and transarterial embolization are commonly used to control active bleeding in patients with RH. The long-term outcome depends on patients’ associated injuries and in-hospital complications.

scholarly journals Deep vein thrombosis and bilateral pulmonary embolism following minor trauma to the popliteal fossa: could this have been avoided?

CJEM ◽  
2011 ◽  
Vol 13 (02) ◽  
pp. 122-126 ◽  
Author(s):  
Jason Orlik ◽  
Jennifer McVey
Keyword(s):  
Deep Vein Thrombosis ◽  
Blunt Trauma ◽  
Pulmonary Embolus ◽  
Doppler Ultrasonography ◽  
Popliteal Fossa ◽  
Minor Trauma ◽  
Likelihood Ratios ◽  
Vein Thrombosis ◽  
Hockey Player ◽  
Deep Vein

ABSTRACT Deep vein thrombosis (DVT) with subsequent pulmonary embolus (PE) is frequently fatal if untreated. Athletes may be susceptible to DVT following minor blunt trauma to the popliteal fossa. We report an adult male hockey player with no “classic” risk factors for DVT who presented with a DVT and bilateral PE following minor popliteal blunt trauma. This case report illustrates the utility of likelihood ratios when interpreting the results of diagnostic tests such as Doppler ultrasonography.

Posttraumatic spinal cord tethering and syringomyelia: surgical treatment and long-term outcome

2009 ◽  
Vol 11 (4) ◽  
pp. 445-460 ◽  
Author(s):  
Scott P. Falci ◽  
Charlotte Indeck ◽  
Daniel P. Lammertse
Keyword(s):  
Spinal Cord ◽  
Spinal Injury ◽  
Treatment Center ◽  
Term Outcome ◽  
Repeat Surgery ◽  
Long Term Outcome ◽  
Progressive Myelopathy ◽  
Cord Injury ◽  
Spinal Cord Tethering

Object Permanent neurological loss after spinal cord injury (SCI) is a well-known phenomenon. There has also been a growing recognition and improved understanding of the pathophysiological mechanisms of late progressive neurological loss, which may occur after SCI as a result of posttraumatic spinal cord tethering (SCT), myelomalacia, and syringomyelia. A clinical study of 404 patients sustaining traumatic SCIs and undergoing surgery to arrest a progressive myelopathy caused by SCT, with or without progressive myelomalacia and cystic cavitation (syringomyelia) was undertaken. Both objective and subjective long-term outcomes were evaluated. To the authors' knowledge, this is the first series of this size correlating long-term patient perception of outcome with long-term objective outcome analyses. Methods During the period from January 1993 to November 2003, 404 patients who had previously sustained traumatic SCIs underwent 468 surgeries for progressive myelopathies attributed to tethering of the spinal cord to the surrounding spinal canal, with or without myelomalacia and syrinx formation. Forty-two patients were excluded because of additional pathological entities that were known to contribute to a progressive myelopathy. All surgeries were performed by the same neurosurgeon at a single SCI treatment center and by using a consistent surgical technique of spinal cord detethering, expansion duraplasty, and when indicated, cyst shunting. Results Outcome data were collected up to 12 years postoperatively. Comparisons of pre- and postoperative American Spinal Injury Association sensory and motor index scores showed no significant change when only a single surgery was required (86% of patients). An outcome questionnaire and phone interview resulted in > 90% of patients self-assessing arrest of functional loss; > 50% of patients self-assessing improvement of function; 17 and 18% self-assessing improvement of motor and sensory functions to a point greater than that achieved at any time postinjury, respectively; 59% reporting improvement of spasticity; and 77% reporting improvement of hyperhidrosis. Conclusions Surgery for spinal cord detethering, expansion duraplasty, and when indicated, cyst shunting, is a successful treatment strategy for arresting a progressive myelopathy related to posttraumatic SCT and syringomyelia. Results suggest that surgery leads to functional return in ~ 50% of patients, and that in some patients posttraumatic SCT limits maximal recovery of spinal cord function postinjury. A patient's perception of surgery's failure to arrest the progressive myelopathy corresponds closely with the need for repeat surgery because of retethering, cyst reexpansion, and pseudomeningocele formation.

scholarly journals Outcomes with advanced versus basic life support in blunt trauma

2020 ◽  
Vol 220 (3) ◽  
pp. 783-786
Author(s):  
Michael S. Farrell ◽  
Benjamin Emery ◽  
Richard Caplan ◽  
John Getchell ◽  
Mark Cipolle ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Basic Life Support ◽  
Life Support

Concomitant Rash and Blood Dyscrasias in Geriatric Psychiatry Patients Treated with Carbamazepine

1998 ◽  
Vol 32 (9) ◽  
pp. 884-887 ◽  
Author(s):  
Marshall Cates ◽  
Richard Powers
Keyword(s):  
Blood Count ◽  
Geriatric Patients ◽  
Complete Blood Count ◽  
Case Reports ◽  
Signs And Symptoms ◽  
Geriatric Psychiatry ◽  
Drug Induced ◽  
Carbamazepine Therapy ◽  
A Prospective Study ◽  
The Relationship

BACKGROUND: Rashes and blood dyscrasias are disconcerting adverse effects associated with carbamazepine therapy. Rashes are quite common, as are mild blood dyscrasias, such as mild leukopenias. Fortunately, severe rashes and blood dyscrasias are rare. There are few reports on the relationship between carbamazepine-induced rashes and blood dyscrasias, including a prospective study in which rash appeared concomitantly with leukopenia and/or thrombocytopenia in 10 patients, two case reports in which simultaneous rash and agranulocytosis occurred, and two case reports in which rashes served as harbingers of fatal aplastic anemia. CASE REPORTS: We report two cases of concomitant rashes and blood dyscrasias in geriatric psychiatry patients receiving carbamazepine therapy for bipolar disorder. One patient was found to have a severe leukopenia within several days after rash onset. The other patient was discovered to have a severe leukopenia and thrombocytopenia within about a month after rash onset. DISCUSSION: Current hematologic monitoring guidelines for carbamazepine rely heavily on the recognition of signs and symptoms of blood dyscrasias by clinicians and patients. We believe that our cases support the suggestion that patients who develop rashes receive more vigilant monitoring of the complete blood count, should carbamazepine therapy be continued. Given the currently available case reports and the fact that the incidence of drug-induced blood dyscrasias increases with advanced age, this recommendation may be particularly relevant for geriatric patients. CONCLUSIONS: Further study is required to establish whether carbamazepine-induced concomitant rashes and blood dyscrasias are valid associations insofar as monitoring is concerned.

Extracorporeal membrane oxygenation for Kawasaki disease: two case reports and the Extracorporeal Life Support Organization experience 1999–2015

Perfusion ◽  
2017 ◽  
Vol 32 (7) ◽  
pp. 609-612 ◽  
Author(s):  
Derek Best ◽  
Johnny Millar ◽  
Igor Kornilov ◽  
Yury Sinelnikov ◽  
Roberto Chiletti ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Extracorporeal Membrane Oxygenation ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Case Reports ◽  
Membrane Oxygenation ◽  
Support Organization ◽  
Life Threatening ◽  
Acute Kawasaki Disease ◽  
Cardiac Manifestations

Kawasaki disease is usually a limited illness of early childhood. However, life-threatening cardiac manifestations can occur, either at acute presentation or as a consequence of coronary arterial involvement. We report the successful use of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) for cardiac support in two children with Kawasaki disease: one with acute Kawasaki disease shock syndrome, the other with complications of coronary arteritis and subsequent surgery. We also reviewed the reported experience in the ELSO database and available literature.

Clinical Toxicology of Yew Poisoning

2018 ◽  
Vol 52 (6) ◽  
pp. 591-599 ◽  
Author(s):  
Alexander W. Labossiere ◽  
Dennis F. Thompson
Keyword(s):  
English Language ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Case Reports ◽  
Data Extraction ◽  
Case Series ◽  
Therapeutic Interventions ◽  
Plant Materials ◽  
Search Terms ◽  
Life Threatening

Objectives: Yew plant materials contain highly toxic taxine alkaloids. Serious ingestions can result in life-threatening toxicity. The purpose of this article is to summarize the literature on the treatment of acute yew poisoning. Data Sources: PubMed (January 1946 to November 2017) was searched using the search terms “taxus/po”. EMBASE (1980 to November 2017) was searched using the search terms “taxus/to” and “yew.mp.” Web of Science (1945 to November 2017) was searched using the text words taxus, taxine, and yew. Study Selection and Data Extraction: Available English language articles involving case reports, epidemiology, treatment, and outcomes were included. Data Synthesis: Although not uncommon, unintentional yew poisoning rarely results in significant morbidity or mortality. A total of 26 case reports of yew poisoning were evaluated along with 4 case series articles (totaling 22 additional cases). Only 4 of the 48 total cases (8%) were accidental poisonings, the rest being deliberate ingestions. In 20 patients (42%), it resulted in fatalities. Severe, acute yew poisoning results in symptomatology largely resistant to pharmacotherapy intervention. Conclusions: Most nonintentional ingestions of yew plant constituents are asymptomatic and require little intervention. Severe poisoning can result in life-threatening cardiac toxicity and require aggressive supportive care. Therapeutic interventions, such as sodium bicarbonate, digoxin immune fab, and hemodialysis that have been utilized in case studies and case series in the literature have little proven benefit. Extracorporeal life support should be considered in severe yew poisoning.

Major trauma

2017 ◽  
Author(s):  
Ashis Banerjee ◽  
Clara Oliver
Keyword(s):  
Emergency Medicine ◽  
Royal College ◽  
Life Support ◽  
Spinal Injury ◽  
Advanced Trauma Life Support ◽  
Trauma Management ◽  
National Guidelines ◽  
Nice Guidance ◽  
Short Answer Question ◽  
Adults And Children

Trauma management is a major presentation in the Royal College of Emergency Medicine (RCEM) curriculum for both adults and children due its associated morbidity and mortality. Trauma management can appear in any aspect of the Fellowship of the Royal College of Emergency Medicine (FRCEM) examination, including the short-answer question (SAQ) paper. This chapter focuses on adult trauma, in accordance with the advanced trauma life support (ATLS) guidelines. It provides information on the different aspects of trauma including that of the chest/abdomen/pelvis, in keeping with ATLS and national guidelines. In addition, this chapter highlights the criteria for imaging and management, which may appear in the SAQ paper. It also has a detailed section on head and spinal injury and is linked to current NICE guidance. Paediatric trauma is not covered in this chapter, however, as it is reviewed in Chapter 19.

scholarly journals Extracorporeal life support as bridge to recovery in yew poisoning: case reports and literature review

2020 ◽  
Author(s):  
Julia Hermes‐Laufer ◽  
Martin Meyer ◽  
Alain Rudiger ◽  
Julian Henze ◽  
Kai Enselmann ◽  
...  
Keyword(s):  
Literature Review ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Case Reports ◽  
Bridge To Recovery ◽  
Poisoning Case
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