Cases reported "Wounds, Penetrating"

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1/127. Central venous access: accidental arterial puncture in a patient with right-sided aortic arch.

    OBJECTIVE: To describe an unusual case of accidental insertion of a central line into an anomalous right-sided aortic arch. DESIGN: Case report, clinical. SETTINGS: Community hospital, university-affiliated. CONCLUSIONS: Intraoperative radioscopy, chest radiographs, and pressure transducer monitoring usually allow for the prompt recognition of the accidental insertion of venous catheters into the arterial system. However, in the presence of a right-sided aortic arch, a central line could be erroneously inserted into the arterial system and the radiologic findings can give the false impression of a correct placement in the superior vena cava.
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2/127. Unusual parotid gland foreign body.

    A foreign body in the parotid gland whether from the oral cavity or through the skin is extremely uncommon. A case is described of the tip of a golden-colored pencil accidentally piercing the deep lobe after a fall. Emergency surgical removal was performed, and the diagnosis of the foreign body was quite easy. In contrast, determination of the location in the gland had to be done by a microscope, with fluoroscopy during the operation and was quite difficult. During removal, great attention was paid to avoiding facial nerve injury. This was done by identifying the facial trunk at the pointer using a microscope. The dissolved material including copper and zinc metal powder, paste, and clay, was found in the deep lobe associated with the surrounding abscess. Although these materials are assumed to be harmless to human tissues, the complete and immediate removal is to prevent salivary fistule resulting from inflammation.
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3/127. Dural puncture and corticotherapy as risks factors for cerebral venous sinus thrombosis.

    Dural puncture with corticosteroid could be a predisposing factor for cerebral venous thrombosis (CVT). A 35-year-old woman using oral contraception was treated with corticosteroid epidural infiltration for L5 radiculalgia. The following day a postural headache developed and accidental dural puncture was suspected. Four days later, she presented with fever and consciousness impairment requiring mechanical ventilation. magnetic resonance angiography (MRA) confirmed thrombosis of the superior sagittal sinus. Recanalization was observed three weeks later and the patient fully recovered. blood tests for thrombophilia showed a moderate decrease in the C protein level (chronometric activity 44%, N = 65-130). CVT has been reported after spinal anaesthesia or peridural anaesthesia with accidental puncture. After dural puncture the decrease of cerebrospinal fluid pressure induces a rostrocaudal sagging effect with traumatic damage to the fragile venous endothelial wall, and may trigger a venous vasodilatation with resultant stasis. CVT has also been described in patients after lumbar puncture and oral corticoid treatment for multiple sclerosis and after corticosteroid intrathecal infiltration. Therefore, corticosteroids can be considered as a potential additional procoagulant stimuli.
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4/127. Incidental gallbladder cancer at laparoscopy: a review of two cases.

    Early peritoneal seeding and trocar site metastasis from gallbladder cancer have been reported after laparoscopic cholecystectomy. Nevertheless, the role of laparoscopy in gallbladder cancer remains controversial. Two cases of early recurrence of carcinoma of the gallbladder after laparoscopic cholecystectomy are described. In the first case, the use of a gasless technique did not prevent an early, diffuse peritoneal dissemination of the disease. In the second case, despite the use of a retrieval bag to extract the gallbladder, multiple metastases around the gallbladder bed and local peritoneal seeding developed. These cases demonstrate that factors other than bile spillage, CO2 inflation, and the use of a retrieval bag are responsible for early dissemination of gallbladder cancer.
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5/127. The farmer's wife and the salmon fork: a near miss for the median nerve.

    This case history illustrates how a farmer's wife accidentally impaled her forearm on a salmon fork with barbs. Despite the fact that the barbs were not obvious to the rescuing firemen, they had the good sense to transfer the patient with the fork in situ and well supported to prevent traction injury. Any effort to remove the fork at the time of injury would have resulted in complete division of the median nerve.
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6/127. popliteal artery pseudo-aneurysm following penetrating trauma.

    popliteal artery pseudo-aneurysm due to accidental penetrating trauma, once common during world wars, is now rare. It may require amputation due to ischaemic complication. One such case is detailed here. The angiographic findings, complications, management and literature review are provided.
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7/127. Maxillofacial-transclival juxtabasilar penetrating butcher's knife injury: a case report.

    A 90-year-old woman presented with an accidental maxillofacial-clival penetrating injury with a butcher's knife, with its tip reaching the immediate proximity of the basilar artery. The knife was removed at surgery, with no untoward sequelae.
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8/127. The rate of hydrocele perforation during vasectomy. Is perforation dangerous?

    BACKGROUND: Hydroceles are not uncommon, are often occult, and may be associated with an inguinal hernia. The rate of hydrocele perforation during elective vasectomy has not been reported in the medical literature. Our objective was to estimate the frequency and consequences of hydrocele perforation incidental to vasectomy. methods: We retrospectively reviewed data from a series of patients undergoing vasectomy using the no-scalpel technique for the incidence of complications. A supplementary chart review was done to determine preoperative conditions, and telephone contacts were made if needed to assess later morbidity. RESULTS: We noted 7 perforations in 150 vasectomies. Only one patient had a hydrocele documented preoperatively. Three had histories of inguinal hernia and herniorrhaphy. Five patients had evidence of minor swelling early on, but none had additional morbidity or long-term associated complications. CONCLUSIONS: This small case series of vasectomies had a 4.7% incidence rate of perforated small or occult hydroceles. physicians should be aware of this potentially alarming but apparently minor phenomenon that may accompany vasectomy.
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9/127. An unusual pulmonary perforation case after chest tube placement.

    Pulmonary laceration is an uncommon complication of tube thoracostomy technique that is expected vigorous clinically and may be fatal. In this study, we report a case of pulmonary laceration owing to a tube thoracostomy, with no clinical signs, and detected incidentally on thorax computed tomography.
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10/127. Non-respiratory tuberculosis with mycobacterium tuberculosis after penetrating lesions of the skin: five case histories.

    Tuberculosis is primarily transmitted from person to person via the respiratory route. We describe five cases of patients who developed tuberculosis at the site of a skin injury: three after being treated repeatedly with local corticosteroids via intramuscular injections, and two who cut themselves accidentally with a knife. All cultures yielded normal-sensitive mycobacterium tuberculosis, and all patients responded well to anti-tuberculosis treatment. These unusual manifestations of non-respiratory tuberculosis may support the assumption that persistent, painful, reddish and/or fistulous areas of the skin might also indicate an infection caused by M. tuberculosis, via either reactivation of pulmonary tuberculosis or primary infection with M. tuberculosis by cutaneous transmission.
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