Acta Chir Belg
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Diaphragmatic rupture after blunt trauma is rare, but indicates a powerful external impact. Associated lesions are often life-threatening and require a rapid diagnosis and management. We report a case of a 24-year-old man, admitted to the emergency department after a serious car accident. ⋯ Closure of a small bowel perforation found during the laparoscopic exploration was also performed. We consider this therapeutic modality to be an excellent approach in the management of acute left side diaphragmatic rupture in haemodynamically stable patients. Firstly, it permits an inspection of the thoracic cavity through the diaphragmatic tear and secondly, an easy repair of damaged structures in the abdominal cavity.
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Fournier's gangrene is a rare, rapidly progressive, necrotising fasciitis of the external genitalia and perineum with high morbidity and mortality. ⋯ Aggressive surgical debridement and combined antibiotherapy are essential in the management of Fournier's gangrene. FGSI and BSA are useful to assess the severity and prognosis of the disease.
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Because of their rarity and late diagnosis, gastro-intestinal bezoars can be treated after the occurrence of some complications such as acute intestinal obstruction, strangulation, decubitus ulceration and bleeding. In this study, reasons for bezoar formation, measures to be taken and treatment modalities were investigated. ⋯ Even though rarely seen in digestive tract diseases, the probability of BZ formation should always be remembered. After the removal of BZs by conservative methods or surgery, precautions should be taken against recurrence and possible underlying psychiatric disorders should be treated.
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Delayed intestinal perforation after blunt trauma is very rare. Peri-appendicitis is the serosal inflammation of the appendix, which is generally caused by extra-appendicular sepsis. Our purpose is to present this case with delayed ileum perforation after blunt trauma and peri-appendicitis. ⋯ Delayed postraumatic perforation of the intestine occurs as a result of ischaemia. There is no reported case of a patient with situs inversus totalis. If acute abdomen is the case even with a history of minimal abdominal trauma, delayed intestinal trauma should be considered in the diagnosis. Peri-appendicitis secondary to intestinal perforation, which is a rare condition, should come to mind at the diagnosis.