American journal of surgery
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The purpose of this study was to define the relative risk of life-threatening sequelae in patients at risk for myocardial contusion. During a 3-year period, 280 patients sustaining blunt chest trauma were admitted to the surgical intensive care unit to exclude myocardial contusion. Patients were evaluated by electrocardiogram and creatine phosphokinase (CPK) MB enzyme levels every 8 hours for a minimum of 48 hours. ⋯ This clinical experience underscores the low incidence of cardiac sequelae among patients at risk for myocardial contusion. Complications were always manifest within 12 hours of injury. The clinical diagnosis of myocardial contusion can be excluded pragmatically in the asymptomatic patient with a normal electrocardiogram and CPK-MB levels during the initial 24-hour postinjury period.
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Aspiration of foreign bodies in children can lead to illness and even death if not recognized and treated promptly. Seventy-six patients were referred to our hospital for suspected foreign body aspiration. The following is a retrospective review of their diagnosis and treatment. ⋯ These children, as a result of a prolonged period before diagnosis, were treated unnecessarily for pneumonia and asthma. Once correctly diagnosed, they had a significantly longer hospital stay. We propose that some negative bronchoscopies are necessary in order to prevent the morbidity that occurs from a missed foreign body aspiration.