Acta chirurgica Scandinavica
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Three cases of carotid artery injury following blunt cervical trauma are reported and the literature is reviewed. The condition carries high morbidity and mortality rates, due to occlusion of the internal carotid artery. The diagnosis is often delayed, as the symptoms of carotid injury frequently are mistakenly attributed to head injury. ⋯ Tomography of the neck following intravenous injection of contrast medium may be useful for demonstrating occlusion of the carotid artery. Heightened awareness of this injury is important for early diagnosis. Immediate revascularization may improve the poor prognosis.
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Polyarteritis nodosa in a 23-year-old man gave rise to caecal perforation, colonic infarction and, later, severe gastrointestinal bleeding with fatal outcome. The necessity of early surgical intervention to improve prognosis in cases with severe gastrointestinal improvement is emphasized.
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Case Reports
Dissection of the abdominal aorta associated with traumatic aneurysms of the iliac vessels. Case report.
Dissection of the abdominal aorta without an associated thoracic dissection is uncommon. It is usually associated with blunt abdominal trauma and commonly presents early with aortic occlusion. A case is presented where abdominal aortic dissection presented two months after lower abdominal trauma. It is suggested that the initiating event in this case was injury to the iliac vessels.
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Case Reports
Spontaneous rupture of the rectum with evisceration of small intestine through the anus. A case report.
Evisceration of small intestine through the anus is a severe and extremely rare condition associated with perforation of the rectum. A case with successful surgical treatment is described.
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Comparative Study
C-reactive protein compared with white blood cell count and erythrocyte sedimentation rate in the diagnosis of acute appendicitis in children.
Acute abdominal symptoms in 162 children were investigated with rapidly quantified C-reactive protein (CRP), white blood cell (WBC) count and erythrocyte sedimentation rate (ESR) as laboratory parameters. When the symptoms had been present for at least 12 hours, the CRP level was greater than 10 mg/l in 72% of cases with histologic evidence of appendicitis, while leukocytosis (WBC greater than 15 000/mm3) and raised ESR (greater than 20 mm/l h) were found in 58% and 51%, respectively. ⋯ With the combination CRP and WBC count (using rise in one or both), 88% of all appendicitis cases could be identified, and at least 96% of those with gangrene or perforation. The predictive value of combined positive CRP and WBC tests was not less than 93%.