Cases reported "Multiple Trauma"

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1/10. Analysis of blunt trauma injuries: vertical deceleration versus horizontal deceleration injuries.

    There are several similarities found in blunt trauma injuries to humans sustained as a result of vertical deceleration (falling) and those sustained as a result of deceleration in a horizontal plane (automobile accidents). However, examination of the patterns of traumatic skeletal injuries can distinguish those injuries associated with falling from heights from those associated with automobile accidents. While there is considerable variation within each type of blunt trauma injury dependent on the angle at which one falls or is struck, there are several characteristic skeletal features associated with each type of trauma. In this study we review both the current literature and human skeletal remains from the University of new mexico's Documented Collection known to have been subjected to blunt trauma. This collection is used to characterize and differentiate the pattern of skeletal injuries to various parts of the body for each type of trauma. These assessments are applied to investigate the traumatic skeletal lesions observed in a forensic case where the manner of death is unknown. Analyses suggest two possible scenarios that would explain the death of the individual investigated, with death most likely related to a vehicular-pedestrian accident.
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2/10. aortic rupture as a result of low velocity crush.

    A case of aortic disruption in a 35 year old lorry driver is described. This occurred as a result of a low velocity crushing force. Clinicians should be aware that this mechanism of injury may result in aortic disruption as well as the more commonly mentioned severe deceleration force.
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3/10. Traumatic partial avulsion of a single right subclavian artery from the aortic arch and definitive repair.

    Blunt injury to the right subclavian artery is a rare complication of severe deceleration trauma often associated with significant morbidity and mortality. We describe an atypical presentation in a patient who sustained a traumatic avulsion of his right subclavian artery arising off the aortic arch. An interposition graft was used to restore the continuity of the artery to the ascending thoracic aorta.
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4/10. Traumatic innominate artery disruption and aortic valve rupture.

    Rapid deceleration injury causing blunt thoracic trauma can result in injury to the thoracic aorta. Rupture of the aortic isthmus is the most common presentation; however, injury can occur more proximally in the arch vessels or the aortic root. We present an unusual case of simultaneous innominate artery disruption with aortic valve rupture after a motor vehicle accident, and we discuss issues surrounding the diagnosis and operative management of this rare, but life-threatening condition.
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keywords = deceleration
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5/10. aortic rupture complicating a fracture of an ankylosed thoracic spine. A case report.

    A 34-year-old man was injured in a motorcycle accident and suffered both aortic rupture and thoracic spinal fracture, complicated by an underlying undetected ankylosing spondylitis. The latter disease can affect the integrity of vascular and spinal structure. aortography is recommended as a high priority for the patient in an unstable cardiovascular condition requiring a definitive diagnosis. aortic rupture and thoracic spine fracture may occur from high energy deceleration trauma. Motor vehicle passenger and pedestrian injuries are most commonly involved, although airline accidents and high falls also generate some cases. Mediastinal widening, displacement of esophagus and trachea, apical dissection of blood, and, especially, paravertebral pleural space widening are common to both injuries. Whereas most mediastinal hematomas are nonaortic in origin, a combined injury must be considered because clinical features may also overlap. These include hypotension (hypovolemic or spinal shock), paraplegia, and severe back pain. In light of the high mortality and time constraints associated with aortic rupture, immediate diagnostic resolution is necessary for appropriate management and priority of investigation.
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keywords = deceleration
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6/10. Porta hepatis disruption from blunt trauma.

    Extrahepatic porta hepatis injuries from blunt abdominal trauma are exceedingly rare; all recently reported cases involve disruption of the common bile duct at its intrapancreatic portion. We herein report a patient with lacerations of the proper hepatic artery and bile duct occurring from deceleration/torsion of the porta hepatis after high speed vehicular collision.
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keywords = deceleration
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7/10. Traumatic rupture of the thoracic aorta. A clinicopathological study.

    In a county hospital serving a population of roughly 240,000, the hospital records from the period 1982 to 1987 included 27 patients who presented with traumatic rupture of the thoracic aorta. Eighteen patients died instantaneously, one was dead on admission, five died in hospital and three survived operation. Two patients had direct cross clamping of the aorta and Dacron interposition graft soon after admission; both survived. The third patient had a Gott shunt and Dacron interposition graft the day after the accident and survived with paraplegia. In all patients who died in hospital except one, the condition was not diagnosed before death. We conclude that traumatic rupture of the thoracic aorta occurs more frequently than is generally thought. Although most patients die at the scene of the accident, a liberal use of angiography is indicated in all trauma cases admitted to hospital with a history of a forceful deceleration or acceleration injury.
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keywords = deceleration
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8/10. Motor vehicle accident associated with minimal maternal trauma but subsequent fetal demise.

    Traumatic fetal injury in the absence of significant maternal injury is rare. A 21-year-old woman at 27 weeks estimated gestational age sustained a front-end motor vehicle collision at 35 mph while wearing a seatbelt and shoulder harness with minimal maternal injury. Marked variable fetal heart rate decelerations were noted on the patient's presentation. Although the initial ultrasound examination was normal, sequential examinations showed an enlarging fetal intracranial mass. Fetal demise occurred five days after the accident with necropsy confirming cerebral hemorrhage, hepatic hemorrhage, and hemoperitoneum. In this case, an abnormality of fetal heart rate first suggested a severe fetal injury, with ultrasonography confirming the injury four days later.
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keywords = deceleration
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9/10. A patient with two chronic posttraumatic aneurysms of the thoracic aorta.

    A case of successful replacement of two coexistent chronic post-traumatic aneurysms of the thoracic aorta is presented. Presumably, these aneurysms at the aortic isthmus and the descending thoracic aorta resulted from two different deceleration traumas.
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keywords = deceleration
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10/10. diagnosis and management of acute aortic valvular disruption secondary to rapid-deceleration trauma.

    Acute aortic valve rupture with resultant aortic insufficiency is a rare complication of blunt trauma. We describe a case in which a patient fell 70 feet, sustaining avulsion of two leaflets of the aortic valve along with multiple other injuries, primarily orthopedic. Our case demonstrates that patients with acute aortic regurgitation can be managed nonoperatively if necessary in the acute setting, enabling management of other significant trauma. Subsequent semielective valvular replacement may be undertaken if other injuries must take precedence.
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ranking = 0.4
keywords = deceleration
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