Cases reported "Wounds, Gunshot"

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11/97. Pseudoaneurysm of the proximal facial artery presenting as oropharyngeal hemorrhage.

    BACKGROUND: Penetrating trauma to the neck traversing zones II and III may cause considerable damage to soft tissues and neurovascular structures. Delayed sequelae of vascular injuries, such as pseudoaneurysm (PA), may present weeks to months after the initial injury. methods: We report an unusual case of a traumatic PA of the proximal facial artery that ruptured into the oropharynx. RESULTS: A 30-year-old man presented with oropharyngeal hemorrhage one month after a gunshot wound to the neck. angiography revealed a PA of the proximal facial artery, which was treated with embolization. The arterial injury leading to the pseudoaneurysm had not been detected by arteriography at the time. CONCLUSIONS: PAs are rare complications of penetrating neck trauma. To our knowledge, this is only the second report of PA involving the proximal facial artery, and the first of a facial PA rupture into the pharynx.
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12/97. Sensory and motor function impairment after brachial plexuscord compression by a pedicled latissimus dorsi flap.

    A case of neuropraxia of the sensory and motor nerve fibres of the brachial plexus is reported after successful transfer of an ipsilateral pedicled myocutaneous latissimus dorsi flap to reconstruct a large-volume tissue defect in the neck resulting from a shotgun injury.
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13/97. Gunshot wounds to the neck.

    Gunshot wounds to the neck are diagnostically and therapeutically challenging cases. We report such a case with vascular and neurologic injuries and describe the therapeutic options. Initial treatment is aimed at hemodynamic stabilization. Zone II neck injuries are managed selectively, and physical examination alone may dictate emergency surgical exploration. spinal cord injury must be suspected and assessed clinically, as well as by computed tomography and angiography. Deteriorating or stable neurologic status and cord compression by bullet or bone fragments require surgical decompression. Improving neurologic status may be managed conservatively. In gunshot wounds to the neck, treatment should be individualized and multidisciplinary.
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keywords = neck
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14/97. air-gun pellet injuries to the head and neck in children.

    air-gun pellet injuries to the head and neck are seldom reported in pediatric practice, although they typically occur in children. The adult skeleton stops these projectiles, but they can easily transverse the thin bones of children. If unnoticed, these apparently trivial injuries may have catastrophic consequences. We report three children who sustained a central nervous system injury resulting from a shot by a compressed-air gun. The true nature and extent of the lesion in two infants was established only by neuroradiological investigations. We also briefly review the management and prevention of this type of injury.
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keywords = neck
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15/97. Priorities in the management of penetrating maxillofacial trauma in the pediatric patient.

    Penetrating facial trauma is uncommon in children; a large series published by Cooper et al revealed that only 1% to 2% of the total population of infants and children admitted for trauma during their study period had a diagnosis of penetrating trauma to the head or neck. Little has been published specifically addressing these injuries in the pediatric population. The records of 20 patients treated for penetrating facial injuries at Kosair-Children's Hospital in Louisville, kentucky from January 1991 through December 1994 were reviewed. The location, mechanism and extent of injury, as well as the diagnostic and management practices used in patient treatment, were collected. Categorizing the injuries relative to the involvement of one or more facial zones helped guide diagnostic studies and therapeutic intervention and predict associated injuries. This article evaluates the authors' method of management and any differences in management between pediatric and similarly injured adult patients.
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keywords = neck
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16/97. Successful endovascular therapy of a penetrating zone III internal carotid injury.

    Penetrating injuries to the internal carotid artery in zone III of the neck can be a significant challenge to the operating surgeon. Direct surgical exposure and repair of the internal carotid artery at the skull base can be extremely difficult, and surgical options for treatment of a pseudoaneurysm at this location are limited. We present a case of an 18-year-old man who sustained a single gunshot wound to the distal cervical internal carotid artery that led to a pseudoaneurysm managed with endovascular exclusion. Recent literature on the surgical and endovascular management of distal carotid injuries is reviewed.
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keywords = neck
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17/97. Combined endovascular and open repair of a penetrating innominate artery and tracheal injury.

    Endovascular therapy affords the opportunity to decrease surgical morbidity and improve operative planning in complex penetrating injuries of the chest. In this case report we describe a hemodynamically stable patient with a single gunshot wound to the base of the neck (zone I), with combined vascular and tracheal injuries. We present a novel approach to the repair of this type of injury using combined endovascular and open techniques.
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keywords = neck
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18/97. Gunshot wounds to the head and neck.

    The types of injury which occur as a result of the civil disturbances in the north of ireland are described. Four cases of gunshot wounds to the head and neck are described, each of particular clinical interest. The recent literature on the subject is reviewed and the consensus of opinion appears to be that the safest policy is to explore all cases of penetrating wounds of the neck
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ranking = 2
keywords = neck
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19/97. Gunshot injury of the proximal femoral physis.

    A 12-year-old boy sustained a gunshot injury to the proximal femur. The bullet hole passed through the femoral neck very close to the proximal femoral physis (Ogden type 8 physeal injury) without neurovascular injury. The boy was treated conservatively with antibiotics and bedrest. Nine months later, avascular necrosis of the femoral head (Ratliff type 2) and limb shortening of 2 cm had developed. For this reason, a valgus intertrochanteric osteotomy was performed 1 year after the injury. However, only partial revascularization of a necrotic femoral head segment occurred. For the residual necrotic segment in the weight-bearing area and progressive shortening of the femur 3.5 years after injury, a valgus-extension intertrochanteric osteotomy was performed and remodelling of the necrotic fragment done. The boy is now over 19 years old. He has only minimal pain after sports activity and a slightly limited range of movement. The limb shortening is 1.5 cm.
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keywords = neck
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20/97. meningitis following gunshot wound of the neck.

    It is generally assumed that a missile fired from a gun is subjected to sufficient heat to render it sterilized. For this reason, retained bullets are not usually considered a source of infection. The infectious complications associated with gunshot wounds are typically attributed to perforation of a hollow viscus with leakage of gastrointestinal contents causing peritonitis or intra-abdominal abscess. There are several reports of bacterial meningitis involving the spinal cord in gunshot wounds that perforate the intestine prior to involving the thoracic or lumbar vertebral column; however, there are no published reports of cerebral meningitis resulting from a retained projectile in the spinal canal in which there was no injury to the gastrointestinal tract. This manuscript describes a woman who died as a result of unsuspected acute bacterial meningitis which developed secondary to a gunshot wound of the neck. The projectile fractured the first thoracic vertebra, lacerated the dura and contused the spinal cord at the C7-T1 junction. meningitis developed at the C7-T1 level and ascended along the cervical spinal cord to the brain. The infection caused acute neurologic deterioration and death four days following the initial injury.
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keywords = neck
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