J Trauma
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Case Reports
Traumatic hemipelvectomy in combination with traumatic amputation of an upper extremity.
This is a report of a 16-year-old survivor of a traumatic hemipelvectomy in combination with an amputation of the upper extremity on the ipsilateral side. The injury was caused when the patient fell under a railroad train. There were associated injuries of the genitourinary tract and the rectum. Factors that contributed to the patient's survival were: 1) the excellent care he received at the scene of the accident by the paramedics of the regional emergency care system; 2) a rapid transportation to the hospital by a life flight helicopter; and 3) a concentrated effort by the general surgery, plastic surgery, and urologic surgery teams in providing vigorous, sustained, and comprehensive preoperative, operative, and postoperative care.
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The psychosocial characteristics of 100 burned children and their families were assessed along with characteristics of the burn event and injury. The findings were compared to other studies of burned children from Australia, Great Britain, and the United States to identify patterns of childhood burn injury. It is concluded that children most at risk for burns are very young and male. ⋯ Moreover, burned children frequently have psychological handicaps and a history of previous burns. These findings and others were used to identify subgroups of children most at risk for burn injury and the most common precipitating events. The importance of prevention of these injuries for professionals dealing with such children is emphasized.
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Foreign body pulmonary emboli from a cranial venous sinus are unusual. Two patients are presented with gunshot wounds to the head who subsequently developed foreign body pulmonary emboli. Neither had any pulmonary complaints at presentation or during followup. Radiologists and primary care physicians should be aware of the possibility of distal missile pulmonary emboli when a foreign body enters the peripheral venous system or an intracranial venous sinus.
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Case Reports
Diagnosis of isolated perforation of the gallbladder following blunt trauma using sonography and CT scan.
Perforation of the gallbladder from blunt abdominal trauma is relatively rare, and is usually diagnosed at laparotomy for associated visceral injury. Isolated injury of the gallbladder may be unrecognized leading to delayed diagnosis and its associated increased morbidity. Computerized tomography, sonography, and HIDA Tc99m may be used in the early diagnosis of the acutely perforated gallbladder.
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Interventional radiology (catheter placement under radiologic guidance) is a safe and effective technique in the management of hemorrhage and infection after hepatic trauma. Twenty procedures in 17 patients were reviewed. All patients with hemorrhage, vascular lesions, and intra-abdominal fluid collections were successfully treated without mortality or substantial morbidity. These techniques are recommended in complicated liver trauma.