Acta Chir Belg
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An unusual patient with chylothorax following blunt chest trauma is presented. Diagnosis was, in this acute case, clear after thoracostomy. In our patient conservative therapy with total parenteral nutrition failed and he was cured with a surgical closure of the duct leak. Chylothorax can be the cause of important morbidity and mortality, and straightforward diagnosis and therapy are mandatory.
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Case Reports
[Transsection of the cervical trachea secondary to a closed injury. Apropos of a case].
The successful surgical management of a case of complete blunt traumatic transection of the cervical trachea is reported. The management of this rare pathology is a real challenge for the surgeon with regard to early recognition of the lesion and proper therapeutic strategy. Except in case of respiratory distress and/or major laryngotracheal lesions, where urgent tracheotomy is recommended, diagnostic fiberoptic bronchoscopy should be performed to assess the lesions. ⋯ During this exploration intubation can be guided by the surgeon and general anesthesia be initiated. In cases of complete transection, end-to-end anastomosis using absorbable sutures, avoidance of protective tracheotomy and postoperative low-dose steroids seems to be the treatment of choice to avoid stenotic sequelae. If a postoperative stenosis occurs, it should be treated by laser before contemplating surgical correction.
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Unstable pelvic ring fractures, during the first days post-trauma, are potentially life-threatening lesions. In the long term, these lesions can lead to important functional deficits. 44 patients with an unstable pelvic ring fracture were included in this study. 35 of which were reevaluated after an average of 19 months. ⋯ Type B fractures, which are only rotationally unstable, have a better final functional result compared with the Type C fractures with rotational and vertical instability. There exists a significant difference between the two groups.
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Tarsometatarsal fracture-dislocations are considered a rare entity. In fact, that kind of trauma is not easy to diagnose, and a lot of those cases are overlooked. We present here the conclusions of a review of the world literature available.