Military medicine
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Case Reports
Occlusion of a wire-reinforced endotracheal tube in an almost completely edentulous patient.
Wire-reinforced endotracheal tubes have been advocated for use where endotracheal tube kinking is a risk. We report on a 79-year-old nearly edentulous male patient in a weakened state who managed to partially obstruct a wire-reinforced endotracheal tube, despite the presence of a soft bite block. The risk of kinking wire-reinforced endotracheal tubes is not mitigated simply because the patient is edentulous. Good monitoring, vigilance by providers and the use of a solid bite block remains critical in the care of these patients.
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During the 4-year military conflict in Croatia, we treated operatively 7,928 casualties. Of those casualties, 172 (2.2%) had penetrating liver injury, mostly sustained by explosive devices. Of these injuries, 90.7% were associated with the trauma of other abdominal and extra-abdominal organs. ⋯ This method was proven salutary in the most detrimental injuries that could not be treated in any other way. Postoperative hemorrhage and intra-abdominal abscesses were complications that needed surgical and ultrasound-guided aspiration, respectively. Numerous heavy injuries of the liver combined with associated trauma of other vital organs are responsible for the high mortality rate of 28.5%.