1/37. Clinical course of acute laryngeal trauma and associated effects on phonation.We report the clinical course of blunt laryngeal trauma in three young patients. All three patients underwent several phoniatric examinations as well as indirect microlaryngoscopy and microstroboscopy. The follow-up period ranged from three to eight months. In the first case, there was isolated haemorrhage of the left vocal fold; in the second, dislocation of the arytenoid cartilage with formation of an adhesion in the area of the anterior commissure; and, in the third, non-dislocated fracture of the thyroid cartilage with development of haematoma in the right hemilarynx and transient vocal fold paralysis. One patient required surgical treatment; however, repositioning of the arytenoid cartilage, attempted seven weeks following the injury, proved unsuccessful. In conclusion, all three patients showed significant limitation of vocal fold vibration many months after trauma which was unrelated to the extent of resulting tissue damage. In all three cases, patients developed secondary posttraumatic functional dysphonia requiring treatment.- - - - - - - - - - ranking = 1keywords = haematoma (Clic here for more details about this article) |
2/37. diagnosis and treatment of expanding haematoma of the lateral abdominal wall after blunt abdominal trauma.We report a rare case of an expanding post-traumatic lateral abdominal wall haematoma. A superselective arteriogram of the deep circumflex iliac artery showed extravasation from the ascending branch, urging emergency therapy. Microcoil and Gelfoam embolisation was successfully performed. Haematomas of the abdominal wall can be divided in the common rectus sheath haematomas and the rare haematomas of the lateral abdominal wall. Differentiating both entities is essential, since there is a strong difference in their vascular supply. The typical vascular supply of the lateral abdominal wall is discussed, with emphasis on the ascending branch of the deep circumflex iliac artery.- - - - - - - - - - ranking = 7keywords = haematoma (Clic here for more details about this article) |
3/37. Spinal epidural abscess following blunt pelvic trauma.A 17-year-old patient with pre-existing grade II spondylolisthesis of L5/S1 sustained a partial disruption of the left sacroiliac joint with haematoma of the iliac muscle after a fall. The haematoma probably led to occlusion of the left ureter, resulting in a urinary tract infection. After initial conservative treatment the patient developed fever and radicular pain of the left leg. magnetic resonance imaging (MRI) revealed a left-sided epidural abscess at L5/S1, which had probably spread from the infected iliac haematoma along the injured sacroiliac joint. Prompt surgical drainage and antibiotic coverage with cefuroxime and flucloxacillin led to rapid clinical improvement. staphylococcus aureus was identified as the pathogen. At follow-up 6 months postoperatively all symptoms had resolved, while MRI still revealed residual osseous oedema of the sacroiliac joint. The haematoma of the iliac muscle resolved without surgical intervention.- - - - - - - - - - ranking = 4keywords = haematoma (Clic here for more details about this article) |
4/37. myositis ossificans traumatica in young children: report of three cases and review of the literature.myositis ossificans traumatica (MOT) is a rare musculoskeletal disorder in young children. Clinical and imaging presentation in the early stage of disease makes it difficult to differentiate between infection and musculoskeletal neoplasms, particularly in the absence of a history of trauma. Three cases of MOT in children under the age of 10 years, two with inferential trauma, are presented and the findings on different imaging modalities are discussed with reference to the existing literature. While findings based on a single imaging technique, including MRI, may be rather non-specific and even misleading, the combination of different modalities can assist in the consideration of MOT as a possible diagnosis. For example, the demonstration of soft-tissue haematoma on US would suggest the traumatic origin. A rational imaging approach is proposed.- - - - - - - - - - ranking = 1keywords = haematoma (Clic here for more details about this article) |
5/37. CT diagnosis of internal mammary artery injury caused by blunt trauma.AIM: To describe the computed tomography (CT) findings associated with active bleeding from the internal mammary artery (IMA) in blunt trauma victims and to assess complications related to IMA haemorrhage. MATERIAL AND methods: All cases of active IMA haemorrhage identified in blunt trauma patients on admission CT were identified from a trauma radiology data base covering 1990-1999. Computed tomography examinations, operative and medical records were reviewed to ascertain CT findings, complications, and patient outcome. The determination of active bleeding required CT evidence of a central contrast blush of CT density within 10 HU of an adjacent artery surrounded by haematoma. RESULTS: Four patients with CT evidence of active IMA haemorrhage were identified. All cases had surgical confirmation of an IMA source of haemorrhage. There were three patients with unilateral and one patient with bilateral IMA disruption. Three patients exhibited clinical signs of cardiac tamponade related to compression of one or more cardiac chambers by the anterior mediastinal haematoma. Sudden clinical deterioration compatible with tamponade developed in all three patients. CONCLUSION: Early CT recognition of active bleeding within the chest can direct rapid surgical or angiographic intervention. On-going blood loss and, in particular, the threat of cardiac tamponade must be considered with IMA injury.- - - - - - - - - - ranking = 2keywords = haematoma (Clic here for more details about this article) |
6/37. Ischaemic ileal stenosis following blunt abdominal trauma and demonstrated by CT.We report a case of blunt abdominal trauma in which delayed ischaemic ileal stenosis occurred. A 24-year-old man presented with symptoms and signs of bowel obstruction 2 weeks after blunt abdominal trauma. Enhanced CT clearly demonstrated a stenotic ileal loop with mural thickening, associated with a mesenteric haematoma. This abnormal ileal loop was resected.- - - - - - - - - - ranking = 1keywords = haematoma (Clic here for more details about this article) |
7/37. Fracture of the penis--diagnosis and management.Fracture of the penis is an uncommon injury, but it occurs most commonly during over enthusiastic sexual intercourse. diagnosis is not difficult but serious complications such as urethral rupture and corporo-urethral fistula may occur. Management should be by early surgical exploration, with evacuation of the haematoma and repair of the tear in the tunica albuginea in order to minimize the length of patient's stay in hospital and avoid complications such as penile deformity and painful penile erections.- - - - - - - - - - ranking = 1keywords = haematoma (Clic here for more details about this article) |
8/37. Handlebar hernia masquerading as an inguinal haematoma.We report a child who sustained a traumatic hernia of the lower abdominal wall after being thrown forward against the handlebar of his bicycle. This is a rare injury in children, and the clinical features mimic an inguinal haematoma. Suspicion should be raised by the immediate appearance of a mass above the inguinal canal following groin injury, particularly if the swelling then disappears with the patient supine.- - - - - - - - - - ranking = 5keywords = haematoma (Clic here for more details about this article) |
9/37. Acute intramural haematoma of the coeliac artery.The report describes a previously healthy 24-year-old women presenting with acute abdominal pain following a hyperextension manoeuvre. The key finding of a continuous bruit with systolic and diastolic components in the epigastric region subsequently led to the diagnosis of an intramural haematoma of the coeliac artery, that caused a subtotal occlusion of the artery. The diagnosis was achieved by both colour-coded duplex sonography and magnetic resonance angiography. The case shows that a conservative management rather than operative reconstruction is justified in an oligo-symptomatic situation with no signs of end-organ damage as in this patient.- - - - - - - - - - ranking = 5keywords = haematoma (Clic here for more details about this article) |
10/37. MR imaging of myocardial haematoma after blunt chest injury.Myocardial contusion after a chest trauma is a frequently under-diagnosed injury. We report two cases of myocardial contusion in which MR imaging, thanks to its contrast capability, was able to assess the presence of a haematoma and in one case to demonstrate the recovery of the lesion.- - - - - - - - - - ranking = 5keywords = haematoma (Clic here for more details about this article) |
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