Curēus
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Inferior vena cava (IVC) is the most commonly injured abdominal vessel in blunt and penetrating abdominal traumas, and its injury carries a very high rate of mortality. Hemodynamic instability at presentation, poor response to resuscitation, the anatomical level of venacaval injury, low Glasgow Coma Score, and concomitant vascular and visceral injuries are the main factors predicting the outcome of the patient. ⋯ Each of these techniques carries its own merits and demerits. This case report is of a patient who survived an infrarenal tear of IVC caused by a firearm injury that was repaired by venorrhaphy at a hospital of Pakistan with limited cardiac and endovascular facilities.
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Necrotizing soft tissue infections (NSTIs) are deadly infections that can involve all tissue layers from the epidermis to the muscle. NSTIs can be difficult to diagnose, as skin manifestations are often absent early in the course of the disease, and they can be difficult to differentiate from simple cellulitis. Definitive diagnosis and treatment occur in the operating room. ⋯ Prior to admission, however, she was found to have an NSTI. The patient went to the operating room and had an extensive debridement followed by prolonged hospital stay. This case highlights the importance of a thorough physical examination in ill-appearing patients with non-specific symptoms, possible sepsis, and any alteration in mental status.