J Trauma
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Blunt chest trauma, if sustained selectively to the midchest or precordium, can result in a variety of cardiac injuries (3, 7). These lesions may involve separately or together all structures of the heart, including pericardium, myocardium, valves, and coronary arteries. Depending on the extent of trauma, such injuries can cause varying amounts of mechanical or electrical dysfunction. ⋯ High-grade atrioventricular (A-V) block has rarely been recognized clinically in association with nonpenetrating heart trauma (1), perhaps because of its rapid replacement by other dysrhythmias. It was, therefore, of interest when a patient presented to this institution in third-degree heart block following a blunt chest injury. Specifics of her illness are discussed.
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A case of crush injury to the lower extremities of an ironworker involved in the demolition of a bridge is presented. Extrication of the entrapped limbs was complicated by weakening of the bridge support due to acetylene torch cutting. After 3 hours the decision was made to complete the traumatic disarticulation of the right knee on site. Essential elements in the successful completion of such field intervention are presented and the unusual features of the case are emphasized.
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A case of false aneurysm of the common carotid artery after blunt trauma is described. We found seven other such cases in the literature. The literature is reviewed and it is concluded that this rare injury should be operated on as soon as the diagnosis has been made. Lateral excision and arteriorrhaphy, or aneurysm resection in larger lesions, are recommended.
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Records of 373 patients with penetrating wounds of the lung seen at the Ben Taub General Hospital over a 1-year period were reviewed. Intercostal tube thoracostomy was the only therapy required in 282 patients. Thoracotomy was performed in 91 patients with repair of a pulmonary lesion in only 45 patients. ⋯ Penetrating lung trauma in the majority of patients may be treated conservatively with a low incidence of infection or complication. Of the patients who require thoracotomy, associated injuries will frequently represent the major operative indication. Early thoracotomy for complication of clotted hemothorax or empyema is encouraged.
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This article reviews the literature on accidental injury in childhood, summarizing incidence rates and outlining the factors which have been cited as affecting pediatric trauma: the host, the agents, and the environment. During childhood, age and sex differences for rates of accidental injury are frequently reported. Vehicular accidents, falls, drownings, burns, and ingestions are found to be common agents of injury to pediatric patients. The home affords a virtual breeding ground for accidents to children; however, parents also play an important role in the child's environment, with their illnesses, preoccupations, or dispositions to (in)action having consequences which may eventuate in injury.