J Trauma
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Case Reports
Transcutaneous balloon catheter tamponade for definitive control of subclavian venous injuries: case reports.
Two cases are presented in which transcutaneous balloon catheter tamponade of exsanguinating infraclavicular injuries was performed in the trauma admitting area. Angiography and venography demonstrated isolated injuries of the subclavian vein tamponaded by the balloon catheter. Balloon catheter tamponade provided emergency control of bleeding in the admitting area and ultimately definitive treatment of the venous injury.
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Case Reports
T-tube intubation in the management of late traumatic esophageal perforations: case report.
Delayed diagnosis of esophageal perforations can lead to high mortality and morbidity and presents a surgical dilemma. A case report of a bullet wound of the esophagus that was diagnosed late is presented. Placement of a biliary T-tube and pleural decortication were carried out after the perforation was found at esophagoscopy. The patient had no fistula nor esophageal narrowing at discharge 31 days after injury.
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Injuries of the inferior vena cava (IVC) require prompt and definitive action. To evaluate our current management strategy, we reviewed 38 patients with IVC trauma treated from 1983 through 1990. Sixteen were injured by gunshots, eight by stabs, and 14 by blunt mechanisms. ⋯ We conclude that inferior vena caval injury remains a highly lethal injury. Successful outcome depends on prompt volume restoration, a stratified selective management approach, and avoidance of hypothermia. Prosthetic vena caval reconstruction represents an acceptable alternative.