1/42. An unusual cause of haemorrhagic ascites following blunt abdominal trauma.Slow intraperitoneal haemorrhage following blunt abdominal trauma may present as haemorrhagic ascites. Such haemorrhage is usually due to rupture of spleen, liver or damage to small bowel mesenteric vasculature. We encountered a patient with bleeding from ruptured exogastric leiomyoblastoma. Two cases of traumatic rupture of gastric leiomyosarcomas have been reported previously. The operative treatment is usually delayed and the diagnosis established only at laparotomy. We suggest a high level of suspicion and early laparotomy.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/42. 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 = 0.5keywords = haemorrhage (Clic here for more details about this article) |
3/42. Unusual presentations of pleomorphic adenoma and adenoid cystic carcinoma of the lacrimal gland.PURPOSE: To report two atypical cases of pleomorphic adenoma and adenoid cystic tumours of the lacrimal gland. methods: Two case reports are presented. The first is of a 65-year-old female with a long history of right hypoglobus with sudden recent worsening. Computed tomography (CT) showed a round, well-defined lesion in the fossa for the lacrimal gland with an anterior hypodense extension suggestive of possible malignancy in a pleomorphic adenoma. The tumour in the second case, a 35-year-old male, was diagnosed after presentation following a relatively minor periorbital injury. The smooth rounded mass on CT scan was suggestive of a benign lacrimal gland tumour. RESULTS: The lesion in case 1 was excised with a diagnosis of haemorrhage within a pleomorphic adenoma. The lesion in case 2 was excised with a diagnosis of adenoid cystic carcinoma of the lacrimal gland with pseudocapsule. CONCLUSIONS: Haemorrhagic cyst developing beneath the pseudocapsule of a pleomorphic adenoma should be considered in the differential diagnosis of secondary development of malignancy in a pleomorphic adenoma. Adenoid cystic tumours of the lacrimal gland can present with a pseudocapsule.- - - - - - - - - - ranking = 0.5keywords = haemorrhage (Clic here for more details about this article) |
4/42. Late cardiac arrhythmias after blunt chest trauma.OBJECTIVE: case reports of two patients who developed fatal cardiac arrhythmias several days after blunt chest trauma. DESIGN: case reports. SETTING: Surgical intensive care unit of a university hospital. patients: A 23-year-old man and a 9-year-old girl with blunt chest trauma and multiple further injuries following car crashes were transferred to our institution. Although ECG on admission was normal, both patients developed fatal cardiac arrhythmias after 6 and 4 days, respectively. In both patients, post-mortem analysis confirmed myocardial contusion without coronary artery lesions. Histological findings included severe interstitial oedema, haemorrhages and infiltration of lymphocytes and neutrophils, fresh myocardial necrosis and fatty degeneration. CONCLUSION: Blunt chest trauma with myocardial contusion may lead to fatal cardiac arrhythmias even after several days, particularly when other severe injuries are present. Thus, a normal ECG on admission and absence of cardiac arrhythmias during the first 24 h of intensive care treatment do not necessarily exclude the occurrence of life-threatening arrhythmias in the further course.- - - - - - - - - - ranking = 0.5keywords = haemorrhage (Clic here for more details about this article) |
5/42. 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 = haemorrhage (Clic here for more details about this article) |
6/42. Traumatic avulsion of the suprascapular artery.Trauma to the subclavian artery and its branches is rare, and usually the result of penetrating injuries. Blunt trauma presents its own peculiar management difficulties, particularly when causing haemorrhage into the thoracic cavity. Cardiothoracic surgeons may be asked to deal with such cases, so an understanding of the anatomy and options for surgical access are essential. We present a case of blunt avulsion of the suprascapular artery resulting in massive haemothorax, a previously unreported injury.- - - - - - - - - - ranking = 0.5keywords = haemorrhage (Clic here for more details about this article) |
7/42. Fatal blunt pancreatic trauma secondary to assault and battery: a case report.The authors report on an fatal case of closed trauma of the pancreas in a context of violence. A 55-year-old man was found unconscious on the sidewalk and died a short time after being taken to the hospital. He had been hit with several punches to the face and abdomen 6 h before. The post-mortem examination showed numerous bruises over the whole body, a haemoperitoneum, a fissuration of the spleen and a massive peripancreatic haemorrhage associated with a complete dilaceration of the pancreas head. Histological examination of the pancreas revealed a massive necrosis associated with a subtotal disappearance of the acini, numerous sites of cytosteatonecrosis and a large haemorrhagic suffusion of the peripancreatic tissue. This case illustrates the possibilities of pancreatic injuries induced by blunt force aimed at the abdomen in a context of violence. Even if this occurs as an isolated injury it can result in rapid death because of the particular type of pancreatic fracture which is frequently involved. In postmortem situations, the pancreas should be systematically checked at necropsy and a histological examination should be carried out at the slightest doubt of a pancreatic lesion or suspicion of blunt force abdominal injuries.- - - - - - - - - - ranking = 0.5keywords = haemorrhage (Clic here for more details about this article) |
8/42. Isolated rupture of an accessory liver from blunt abdominal trauma in childhood.An accessory liver is uncommonly encountered in surgical practice. It can rarely cause acute abdominal pain. An isolated injury to an accessory liver from blunt trauma in a 10-year-old boy caused major intraperitoneal haemorrhage. laparotomy and excision of the lacerated accessory liver lobe was necessary; the patient recovered uneventfully. The literature on accessory liver is reviewed.- - - - - - - - - - ranking = 0.5keywords = haemorrhage (Clic here for more details about this article) |
9/42. Control of haemorrhage from hepatic vein and vena cava after blunt trauma.A case of uncontrollable haemorrhage after blunt liver trauma is described in which a technique was used to expose rapidly and ligate the right hepatic vein, and suture the vena cava at the expense of the right lobe of the liver. It is believed that this method may be appropriate and life saving when techniques of vascular isolation of the liver appear too cumbersome in the emergency situation.- - - - - - - - - - ranking = 2.5keywords = haemorrhage (Clic here for more details about this article) |
10/42. Endovascular treatment of massive retroperitoneal haemorrhage due to inferior adrenal artery injury. A case report.Massive retroperitoneal haemorrhage because of adrenal bleeding following blunt trauma is a rare entity. We describe a 23-year-old woman with massive retroperitoneal haemorrhage as a result of inferior adrenal artery (IAA) disruption following a car accident. Superselective transcatheter embolization of the IAA using polyvinyl alcohol particles was performed successfully to control haemorrhage. To our knowledge, this is the second report of massive retroperitoneal haemorrhage caused by IAA disruption successfully treated by transcatheter embolization.- - - - - - - - - - ranking = 4keywords = haemorrhage (Clic here for more details about this article) |
| | Next -> |