Cases reported "Wounds, Penetrating"

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1/87. Bone cyst of a fishy origin: from an old catfish spine puncture wound to the foot.

    A rare first metatarsal unicameral-type bone cyst with a deceptive radiographic appearance and size and an unusual pathological etiology was identified in a female patient. This eccentric cyst was observed only postoperatively by radiograph. review of the patient's history documented a foot injury from a catfish spine as the etiology of this chronically inflamed cyst.
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2/87. 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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3/87. vancomycin-resistant Enterococci infected puncture wound to the foot. A case report.

    vancomycin is often administered empirically to patients with osteomyelitis, septic arthritis, septic throbophlebitis, infected burns, and cellulitis of the lower extremities when methicillin-resistant staphylococci are suspected, or when a staphylococcus organism is suspected in a penicillin-allergic patient. physicians must be aware of the guidelines established regarding the use of vancomycin to avoid bacterial resistance. physicians also must be aware of the procedures that have been developed to help contain nasocomial outbreaks of vancomycin-resistant Enterococci.
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4/87. subcutaneous emphysema of a digit through a pre-existing puncture wound.

    A case of injection of compressed air into a digit is reported. The air was injected at 50 PSI through a trivial puncture wound sustained some hours previously. The case had a benign course, in comparison to high pressure injection injuries with foreign material.
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5/87. Sea urchin puncture resulting in PIP joint synovial arthritis: case report and MRI study.

    Of the 600 species of sea urchins, approximately 80 may be venomous to humans. The long spined or black sea urchin, Diadema setosum may cause damage by the breaking off of its brittle spines after they penetrate the skin. synovitis followed by arthritis may be an unusual but apparently not a rare sequel to such injury, when implantation occurs near a joint. In this case report, osseous changes were not seen by plain x-rays. magnetic resonance imaging (MRI) was used to expose the more salient features of both soft tissue and bone changes of black sea urchin puncture injury 30 months after penetration. In all likelihood, this type of injury may be more common than the existing literature at present suggests. It is believed to be the first reported case in this part of the world as well as the first MRI study describing this type of joint pathology. Local and systemic reactions to puncture injuries from sea urchin spines have been described previously. These may range from mild, local irritation lasting a few days to granuloma formation, infection and on occasions systemic illness. The sea urchin spines are composed of calcium carbonate with proteinaceous covering. The covering tends to cause immune reactions of variable presentation. There are only a handful of reported cases with sea urchin stings on record, none of them from the Red Sea. However, this condition is probably more common than is thought and can present difficulty in diagnosis. In this case report, the inflammation responded well to heat treatment, mobilization and manipulation of the joint in its post acute and chronic stages. As some subtle changes in soft tissues and the changes in bone were not seen either on plain x-rays or ultrasound scan, gadolinium-enhanced MRI was used to unveil the marked changes in the joint.
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ranking = 1.5
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6/87. 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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ranking = 2.25
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7/87. Occult craniocerebral injuries from dog bites in young children.

    Although dog bite injuries to the head and scalp of children occur frequently, penetrating dog bite wounds to the cranial vault occur only occasionally and may go unnoticed on initial examination. Substantial morbidity and mortality can ensue if these penetrating injuries are not detected and treated. The authors detail the evaluation of dog bites of the scalp in young children. They highlight the ease with which puncture wounds of the calvarium may be missed during physical examination as a result of scalp displacement at the time of puncture. The cranial puncture may not be large and may later be covered by scalp that returns to its native position. Well-scrutinized skull films and a careful, methodical physical examination are advocated. Recognized craniocerebral injuries should be explored. Depressed cranial fractures should be irrigated, debrided, and elevated. Dural tears should be repaired. Expedient management is necessary to prevent meningitis and its associated sequelae.
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ranking = 0.75
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8/87. High-pressure injection injuries to the hand.

    High-pressure injection injury hides the true extent of the lesions behind an apparent small and harmless puncture of the finger or the hand. Through clinical description, we wish to point out the need for prompt treatment to avoid mutilating and function-threatening complications. We wish to outline the role of the emergency physician who must be aware of the incidence of high-pressure injection injury and become accustomed to early referral to a surgeon, experienced in extensive surgical exploration, removal of foreign bodies, and rehabilitation. The open-wound technique gives the best results. We also point out that failure to refer may become an increasing focus of negligence claims.
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ranking = 0.25
keywords = puncture
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9/87. Absence of hemodynamic and ECG changes in a patient with traumatic left ventricular injury and puncture of the left anterior descending branch.

    patients with penetrating cardiac injury usually present with cardiac tamponade and shock upon hospital arrival. However, absence of hemodynamic depression does not exclude a potentially fatal injury of the heart. This article reports on a patient who developed neither hemodynamic depression nor ECG changes for several hours, despite two left ventricular lacerations with puncture of the LAD. echocardiography is advocated as the diagnostic tool of choice, and it is emphasized that no penetrating objects should be removed from the wound before surgical access to the heart is established, as this may result in the sudden development of cardiac tamponade.
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ranking = 1.25
keywords = puncture
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10/87. phlebotomy-related lateral antebrachial cutaneous nerve injury.

    Although phlebotomy is a common and widespread procedure, the medical literature provides limited information in terms of the documented complications of venipuncture. documentation of phlebotomy-related nerve injuries is even more limited. The authors present a case report of a phlebotomy-induced lesion of the lateral antebrachial cutaneous nerve. According to our literature search, this is the first case in which electrodiagnostic studies were used to document venipuncture-related injury of the lateral antebrachial cutaneous nerve. Specific electrodiagnostic testing is used to definitively diagnose this rare injury and to track recovery. Electrodiagnostic testing can be helpful in evaluating cases of sensory disturbance after phlebotomy.
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ranking = 0.5
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