Eur J Trauma Emerg S
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Injuries to the pancreaticoduodenal complex present a significant challenge both in diagnosis and management. The retroperitoneal location of the pancreas means that it is not a common site of injury, but this also contributes to the difficulty in diagnosis, as the organ is concealed, and investigation often results in delay with its attendant increase in morbidity. ⋯ In many cases the surgical management is relatively simple, but occasionally complex and technical surgical solutions are necessary and the position of the pancreas makes its access and all procedures on it challenging. To compound this, pancreatic trauma is associated with a high incidence of injury to adjoining organs and major vascular structures, which adds to the high morbidity and mortality, and complications occur in 30-60% of patients [1, 2].
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Eur J Trauma Emerg S · Aug 2008
Popliteal A-V Fistula with Pseudo-aneurysm: A Complication Following Total Knee Arthroplasty.
Arthroscopy and total knee replacement (TKR) are the two orthopedic procedures in which instruments are routinely placed near the posterior capsule of the knee. A review of the literature demonstrated that the four commonest reported problems following TKR are thrombosis, arterial transection, A-V fistula, and aneurysm formation. ⋯ Despite the uncommon occurrence of these injuries, the outcome can be devastating, leading to further surgery, including vascular repair or possibly even amputation of the affected limb. We present a rare case of popliteal A-V fistula following TKR and discuss the probable etiology and the management.
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Intra-abdominal organs, most commonly the spleen and liver, are injured in 40-50% of polytraumatized patients. Because of its important immunological functions, preservation of the injured spleen is of paramount importance. ⋯ In trauma cases, every attempt should be made to save the spleen. If splenectomy cannot be avoided, the splenectomized patient should be immunized against pneumococcus and be informed of his/ her resultant immune deficiency.