Military medicine
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Two 18-year-old men were seen for second-degree burns to the dorsum of their knees, ankles, and feet. Upon investigation, it was revealed that the burns were self-inflicted and resulted from the application of crushed garlic with the intent of exemption from work. ⋯ The sharp demarcation line between normal and abnormal skin should suggest that a burn is not from hot liquids. Health care providers had best be advised of the side effects of natural remedies and be aware of how garlic may be abused to the advantage of an individual.
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Delayed hemothorax after blunt trauma is a rare, significantly morbid entity described in the current literature associated with displaced rib fractures. This report describes a case of delayed hemothorax after blunt trauma without rib fracture. The patient presented to a routine clinic appointment 72 hours after injuring himself while snowboarding. ⋯ Repeat radiographs revealed a large right-sided hemothorax. The patient was treated with tube thoracostomy and remained an inpatient for 6 days. This case is unique because, unlike previously reported delayed hemothorax after blunt trauma, this patient had no evidence of rib fractures.
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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%.