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.

Ruptured Gallbladder: Delayed Presentation After Motor Vehicle Collision

2009 ◽  
Vol 67 (6) ◽  
pp. 1451
Author(s):  
Denise M. Torres ◽  
Abhijit S. Pathak ◽  
Paola G. Pieri ◽  
Thomas A. Santora ◽  
Gary Cohen ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Collision ◽  
Delayed Presentation ◽  
Vehicle Collision

Delayed presentation of pericardial tamponade following blunt chest trauma

2021 ◽  
Vol 14 (3) ◽  
pp. e240317
Author(s):  
Eldon Matthia ◽  
Ellery Altshuler ◽  
Dhaval K Naik
Keyword(s):  
Pericardial Effusion ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Motor Vehicle ◽  
Pericardial Tamponade ◽  
Clinical Suspicion ◽  
Delayed Presentation ◽  
Shortness Of Breath ◽  
Delayed Onset ◽  
Vehicle Collision

We present a case of delayed-onset pericardial tamponade nine weeks after a blunt chest trauma. The patient is a 77-year-old man who presented with shortness of breath nine weeks after fracturing his sternum in a head-on motor vehicle collision. CT and echocardiography revealed a massive pericardial effusion prompting pericardiocentesis. Eight hundred millilitres (mL) of fluid were drained, which rapidly improved his symptoms. This is the longest reported interval between the development of tamponade and a blunt chest trauma. Our case illustrates the importance of maintaining a clinical suspicion for effusion and tamponade even weeks after non-penetrating chest wall injuries.

scholarly journals Perforated Small Intestine: A Case of a Delayed Presentation of an Intra-Abdominal Injury in a Pediatric Patient With a Seatbelt Sign

2019 ◽  
Vol 13 ◽  
pp. 117955651987663
Author(s):  
Gregory M Taylor ◽  
Jonathan P Zygowiec ◽  
Laurie C Wallace ◽  
Dawn C Zelenka-Joshowitz ◽  
Angel F Chudler
Keyword(s):  
Abdominal Wall ◽  
Motor Vehicle ◽  
Exploratory Laparotomy ◽  
Abdominal Injury ◽  
Free Fluid ◽  
Delayed Presentation ◽  
Pattern Of Injury ◽  
Vehicle Collision ◽  
Free Air ◽  
Initial Imaging

With the use of seatbelts comes a unique injury profile that has been called “the seatbelt syndrome.” The classically described “seatbelt sign” has become a pattern of injury, describing potential underlying damage. As a clinician, clues to the underlying damage follow a thorough physical examination including the removal of all clothing to locate abrasions and bruises to the skin that potentially follow a seatbelt pattern. Delayed presentation of an intra-abdominal injury in the setting of a seatbelt sign has been well documented; however, the question is how long to observe these patients. We present the case of a 17-year-old woman involved in a motor vehicle collision who presented to the emergency department (ED) hemodynamically stable with a lower abdominal wall seatbelt sign. Her initial imaging revealed only an abdominal wall contusion. She was admitted for observation. Approximately 12 h later she started developing abdominal pain, and by 14 h abdominal distention, with repeat imaging showing free fluid and free air. She was taken to the operating room for an exploratory laparotomy and was ultimately discharged back home on day 7.

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 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 (P2-59) Monocular Vision Loss Following Blunt Trauma

2011 ◽  
Vol 26 (S1) ◽  
pp. s155-s155
Author(s):  
P.M. Pustinger ◽  
D. Paratore
Keyword(s):  
Blunt Trauma ◽  
Vision Loss ◽  
Motor Vehicle ◽  
Pediatric Population ◽  
Rear Seat ◽  
Monocular Vision ◽  
Delayed Presentation ◽  
Case Presentation ◽  
Vehicle Collision ◽  
History Of

Blunt trauma is a leading cause of injury in the teenage population. The early detection of injury is the primary goal of emergency medicine in order to maintain an optimal functional capacity. This is of particular importance in the pediatric population. The following is a case presentation of monocular vision loss in a 14-year-old girl as a result of traumatic optic neuropathy. A motor vehicle collision was the cause of injury for this patient. She was an unrestrained rear seat passenger and struck her head on the driver's headrest during a frontal impact. A delayed presentation of over seven hours added to the complexity of this presentation. Further, a non-contrasted computed tomography (CT) scan of the head and orbits was unremarkable except for soft tissue swelling. The child was left with only light perception in the affected eye. This case presentation will illustrate the importance of immediate care, diagnostic studies, proper consultant input, follow-up care, and the natural history of the injury for this most unusual case.

scholarly journals Delayed Presentation of Intussusception with Perforation after Splenectomy in Patient with Blunt Abdominal Trauma

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Ibrahim Afifi ◽  
Hassan Al-Thani ◽  
Sajid Attique ◽  
Sherwan Khoschnau ◽  
Ayman El-Menyar ◽  
...  
Keyword(s):  
Small Bowel ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Delayed Diagnosis ◽  
Rare Event ◽  
Exploratory Laparotomy ◽  
Adult Intussusception ◽  
Delayed Presentation ◽  
Ileocecal Junction ◽  
Fall From Height

Adult intussusception (AI) following blunt abdominal trauma (BAT) is a rare surgical condition. We present a case of delayed diagnosis of ileocecal junction intussusception with a perforation of small bowel in a 34-year-old male with a history of fall from height. Initial exploratory laparotomy revealed shattered spleen requiring splenectomy. Initial abdominal computerized tomography scanning (CT) scan showed dilated small bowel with no organic obstruction. Patient started to improve with partial distention and was shifted to rehabilitation unit. On the next day, he experienced severe abdominal distention and vomiting. Abdominal CT showed characteristic intussusception at the distal ileum. Secondary exploratory laparotomy revealed severe adhesions of stomach and small bowel to the anterior abdominal wall with dilated small bowel loops and intussusception near the ileocecal junction with perforation of small bowel. The affected area was resected and side-to-side stapled anastomosis was performed. Though small bowel intussusception is a rare event, BAT patients with delayed symptoms of bowel obstruction should be carefully evaluated for missed intussusception.

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.

scholarly journals Motion perception as a risk factor for motor vehicle collision involvement in drivers ≥ 70 years

2021 ◽  
Vol 151 ◽  
pp. 105956
Author(s):  
Thomas A. Swain ◽  
Gerald McGwin ◽  
Joanne M. Wood ◽  
Cynthia Owsley
Keyword(s):  
Risk Factor ◽  
Motion Perception ◽  
Motor Vehicle ◽  
Motor Vehicle Collision ◽  
Vehicle Collision
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