Southern medical journal
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Southern medical journal · Nov 2002
Epidemiology of fatal occupational injuries in Jefferson County, Alabama.
In Alabama, little is known about the overall characteristics of job-related injuries. ⋯ High-risk industries should consider worker-targeted injury prevention programs, and particular attention should be paid to elderly workers.
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Lightning strikes may cause a constellation of injuries. Blunt head trauma, neurologic injury, and cardiac injury are common in these patients. ⋯ Thorough evaluation of all organ systems is crucial. This report discusses mechanism of injury and describes initial evaluation and treatment of lightning strike victims.
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Southern medical journal · Sep 2002
Case ReportsPosterior ischemic optic neuropathy related to profound shock after penetrating thoracoabdominal trauma.
Ischemic optic neuropathy is a rare cause of blindness reported most commonly in association with collagen-vascular diseases, infectious processes, and systemic hypotension related to massive exsanguinating hemorrhage. We report what we believe to be the first case of posterior ischemic optic neuropathy due to perioperative hypotension in a patient who had a penetrating thoracoabdominal injury with massive hemorrhage, severe hypotension, massive microcapillary circulatory leak, multiple system organ failure, and acute respiratory distress syndrome. Although the incidence of postoperative visual loss is low (-0.002%), awareness of this entity must be raised within the trauma surgical community.
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We describe a case of primary aortoenteric fistula (PAEF) in a patient with upper gastrointestinal bleeding. Primary aortoenteric fistula is a rare but clinically important cause of catastrophic gastrointestinal bleeding. ⋯ Primary aortoenteric fistula should be considered in any patient known to have an abdominal aortic aneurysm who presents with upper gastrointestinal bleeding when no identifiable source of bleeding is found on upper endoscopy. Computed tomography may confirm the diagnosis and emergency exploratory laparotomy should be done as soon as the diagnosis is considered clinically.