Eur J Trauma Emerg S
-
Thoracoscopy has numerous applications for both diagnosis and treatment in thoracic trauma. It is excellent for the diagnosis of diaphragmatic injuries, mediastinal evaluation, and the assessment of persistent air-leak. It offers therapeutic intervention for diaphragmatic lacerations, thoracic bleeding in stable patients, evacuation of residual hemothorax, air-leaks, and the prevention and treatment of empyema. Judiciously applied, it is a powerful tool in the armamentarium of the trauma surgeon.
-
Despite significant improvements in the practice of metabolic support of critically ill patients in recent years, malnutrition continues to be common among surgical patients, adding significantly to complications, infections, length of stay, costs, and increased mortality. Furthermore, hypercatabolism is the major metabolic response after major trauma and emergency surgery, making this patient population a unique subgroup of critically ill patients vulnerable to further decline in nutritional status. Many questions have already been answered, such as whether critically ill patients should be fed, when they should be fed, and how nutrients should be delivered. What is not entirely clear is what we should feed critically ill patients at different phases of specific diseases and disorders, as well as whether or not we should enhance and/or modulate patients' immunity.
-
Chylothorax is a very rare disease, and its diagnosis following blunt chest trauma is exceptional. Only a small number of cases have been reported in the literature. We report a case of a male patient involved in a car accident presenting a delayed chylothorax after blunt chest trauma with a bilateral serial rib fracture and fracture of the ninth thoracic vertebrae. ⋯ Thoracoscopic ligation of the thoracic duct is then required. Severe consequences, such as cardiopulmonary abnormalities and metabolic, nutritional and immunologic disorders, can result from chylothorax. Our patient was treated successfully by chest drainage and parenteral nutrition.
-
Eur J Trauma Emerg S · Feb 2010
Inframesocolic Abdominal Aortic Injury and Lumbar Vertebral Body Fracture Secondary to Hyperextension with Blunt Trauma.
This case study describes an abdominal aortic injury and lumbar vertebral body fracture after blunt trauma. Abdominal aortic pseudoaneurysm is a rare complication of blunt abdominal trauma. Recent data reveal seven other reports in the literature. We describe a case of an inframesocolic abdominal aortic injury and lumbar vertebral body fracture from blunt trauma in a 16-year-old male after a hyperextension injury while body board surfing.