Acta Chir Belg
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Comparative Study
Multiple trauma in patients of 65 and over. Injury patterns. Factors influencing outcome. The importance of an aggressive care.
In a first study of 416 polytrauma patients, 49 were aged 65 years or older. These "old patients" (mean age 72.1) were compared with the remaining 367 "young patients" (mean age 31.3). In a second study concerning 126 polytrauma patients of 65 and over, the survivors and non survivors were profiled and compared. ⋯ On the other hand the Glasgow Coma Scale (GCS) was of important prognostic value, as well as to survival as to functional recovery (p < 0.001). Also the need for early intubation and continued ventilation were predictive of survival (p < 0.001). Nevertheless this need for respiratory assistance was not an indication for withdrawing support as also 9% of the survivors required endotracheal intubation for 5 days or longer.(ABSTRACT TRUNCATED AT 250 WORDS)
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Abdomino-thoracic wounds caused by shooting are very serious as they frequently affect several organs and require extreme emergency surgery. Within traumatic abdominal vascular wounds, aortic injury in the supramesocolic segment is associated with a high mortality, 64% (2). ⋯ The evolution has been simple, the patient leaving the hospital 19 days after surgery. This case presents a tactical peculiarity about the access procedure to the supramesocolic abdominal aorta through the great epiploon, dividing the gastro-colic and the gastro-splenic ligaments.
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Review Case Reports
Atraumatic splenic rupture in the course of a pneumonia with Streptococcus pneumoniae. Case report and literature review.
Atraumatic splenic ruptures in the course of infectious diseases are rare but have been reported. Various germs of viruses can be at the origin of such rupture. The more often quoted viral disease is infectious mononucleosis. ⋯ Rupture mechanism is not clearly elucidated; it can be connected with sepsis diffusion at spleen level via haematogenic way and consequently splenomegaly. Splenic rupture following septicaemia does not always entail major splenomegaly nor abscess formation but the attack of the splenic tissue itself is sometimes sufficient to bring about the rupture. The present case of atraumatic splenic rupture on spleen sepsis, no abscess, starting from a pulmonar infection with Streptococcus pneumoniae is, to our knowledge, the first case reported in literature.
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Review Case Reports
[Delayed perforation of the sigmoid colon following closed abdominal trauma. Apropos of a case report].
Blunt abdominal trauma and delayed colon perforations are not common and usually occur in patients sustaining other injuries, but also as isolated event. We report a case of delayed perforation of sigmoid colon, three days after a blunt abdominal trauma in a male adult. It was caused by disinsertion of sigmoid colon mesentery for about ten centimeters. This condition is discussed with literature review.