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Spontaneous Dissection of the Carotid and Vertebral Arteries — NEJM
Clearly, however, these events differ from the traumatic causes of arterial dissection, such as the serious head or neck trauma encountered in motor vehicle accidents33 or the less forceful but focal trauma to the anterolateral part of the ... dissection is being diagnosed in many patients who present with subtle manifestations of the disease.42-44 Most patients have at least two symptoms, although symptoms may occur in isolation and some dissections remain asymptomatic. ...
An unusual case of penetrating tracheal ("Cut throat") injury due ...
Management of penetrating laryngotracheal injuries. Head Neck 1995;17:494-502. Back to cited text no. 4 [PUBMED]. 5. Rao PM, Novelline RA, Dobins JM. The spherical endotracheal tube cuff: A plain radiographic sign of tracheal injury. ...
aipg q 2008
crohn's b. ulcerative colitis cd 104. definition of penetrating neck trauma.. a. disruption of platysme b. 2 cm deep cd 105. false about vovulus is.. a. sigmoid is more common b. sigmoidoscopy is contraindicated c. h/o pain releived by ...
Penetrating Neck Trauma
20 PENETRATING NECK TRAUMA
Clay Cothren M.D., Ernest E. Moore M.D.
1. Why are penetrating neck wounds unique?
Show answer
Although comprising only a small percentage of body surface area, the neck contains a heavy concentration of vital structures.
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Penetrating Abdominal Trauma. Controversy
CONTROVERSY
14. What is the role of laparoscopy and thoracoscopy after penetrating abdominal trauma?
Show answer
Although an intriguing diagnostic modality with additional therapeutic capabilities, laparoscopy thus far appears to have limited application after trauma. With the exception of suspected diaphragmatic injury, an isolated solid organ injury, or evaluation for peritoneal penetration, laparoscopy has yet to demonstrate advantages over the algorithm delineated above. The potential for missed injuries, poor evaluation of the retroperitoneum, and expense are major drawbacks. In patients with wounds to the lower chest with pneumothorax (and, thus, an indication for chest tube placement), thoracoscopy is reasonable to exclude diaphragmatic injury.
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28 TRAUMA TO THE COLON AND RECTUM
W. Andrew Lawrence M.D., Jon M. Burch M.D.
COLON TRAUMA
1. How do most colon injuries occur?
Show answer
Nearly all (> 95%) colon injuries are caused by penetrating trauma from gunshot, stab, iatrogenic, or sexual injury. Blunt colonic trauma is rare and usually results from seat belts during motor vehicle accidents.
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colonic injury grade, iatrogenic colon injury, trauma dos colons, trauma of the colon,Hepatic & Biliary Trauma
25 HEPATIC AND BILIARY TRAUMA
Reginald J. Franciose M.D., Ernest E. Moore M.D.
1. How often is the liver injured in trauma?
Show answer
The liver is both big and central, so it is an easy target.
2. Do the liver and spleen respond similarly to injury?
Show answer
No. The liver has a unique ability to establish spontaneous hemostasis even with extensive injuries. For this reason, the majority of liver injuries in hemodynamically stable patients can be managed nonoperatively. In contrast, many splenic fractures continue to bleed; therefore, a greater percentage require operative intervention.
Trauma To The Colon & Rectum. Rectal Trauma
RECTAL TRAUMA
9. How do rectal injuries occur?
Show answer
Similar to colon injuries, most rectal injuries result from penetrating trauma. Blunt pelvic fractures should be assessed with a strong suspicion for rectal (and urethral) injury.
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colon rectal trauma, rectal injuries, trauma of the colon, colon trauma and antibiotics, demetriades d penetrating colon injuries requiring resection: diversion or primary anastomosis? an aast prospective multicenter study, principles of rectal trauma, recovery time for rectal trauma, rectal trauma, rectum trauma, suspection rectal injury, thorough examination in rectal trauma, trauma colorectal, trauma de recto extraperitoneal, trauma to the colon,Penetrating Thoracic Trauma
22 PENETRATING THORACIC TRAUMA
Jeffrey L. Johnson M.D., Ernest E. Moore M.D.
1. How often do patients with penetrating chest wounds need an operation?
Show answer
Surprisingly rarely. Most civilian penetrating injuries are from knives and low-energy handguns. Consequently, although injuries to the chest wall and lung are common, the majority of patients can be treated with tube thoracostomy alone. Formal thoracotomy or median sternotomy is required in < 15% of isolated penetrating chest injuries.
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www answers com trauma diaphragm,Penetrating Abdominal Trauma
24 PENETRATING ABDOMINAL TRAUMA
Clay Cothren M.D., Ernest E. Moore M.D.
1. Why is there a different approach to stab and gunshot wounds?
Show answer
Whereas one third of stab wounds to the anterior abdomen do not penetrate the peritoneum, 80% of gunshot wounds violate the peritoneum. Furthermore, penetration of the peritoneum by a bullet is associated with visceral or vascular injuries in > 95% of cases, whereas only one third of stab wounds violating the peritoneal cavity produce significant injury. (See Figure 24-1.)
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Hepatic & Biliary Trauma. Operative Management Of Liver Injury
OPERATIVE MANAGEMENT OF LIVER INJURY
11. How are acute liver injuries classified?
Show answer
Liver wounds are generally graded on a scale of I to VI according the depth of parenchymal laceration and involvement of the hepatic veins or retrohepatic portion of the inferior vena cava. Optimal methods of obtaining hemostasis vary with the severity of the injury.
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88 CONGENITAL CYSTS AND SINUSES OF THE NECK
Frederick M. Karrer M.D., Denis D. Bensard M.D.
1. What are branchial cleft anomalies?
Show answer
Cysts, sinuses, and fistulas that result from incomplete obliteration of the first, second, or third branchial clefts, and are present in early fetal development.
Hepatic & Biliary Trauma. Biliary Tract Injury
BILIARY TRACT INJURY
22. Why are complications associated with bile duct leaks?
Show answer
Bilomas (i.e., collections of bile) frequently become infected and may result in lethal peritonitis. Biliopleural fistula, a communication between the biliary system and pleural cavity, persists because of the relative negative pressure in the thorax and may result in a bile empyema.
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biliary trauma, trauma hepatic, biliary tract injury, billiary trauma and its management, fistula biliopleural trauma, hepatic trauma, hepatic trauma and its management, liver trauma and biliary stenting, trauma to biliary tract,Lower Urinary Tract Injury & Pelvic Trauma
31 LOWER URINARY TRACT INJURY AND PELVIC TRAUMA
Fernando J. Kim M.D., Siam Oottamasathien M.D.
1. What are the causes of bladder injury?
Show answer
Iatrogenic manipulation and penetrating or blunt trauma. Because of the rich detrusor blood supply, bladder injury is usually accompanied by hematuria. Other signs may include suprapubic pain, inability to void, or incomplete recovery of catheter irrigation.
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Neck Masses
67 NECK MASSES
Nathan W. Pearlman M.D.
1. What causes lumps in the neck?
Show answer
Enlarged lymph nodes, benign or malignant tumors, congenital abnormalities, and normal anatomy.
2. Can neck masses be part of normal anatomy?
Show answer
Yes. In some patients, the neck mass is nothing more than a submaxillary gland or omohyoid muscle that has become prominent with aging and loss of surrounding fat. This finding usually is apparent if the other side of the neck is carefully examined.
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Blunt Thoracic Trauma
21 BLUNT THORACIC TRAUMA
Jeffrey L. Johnson M.D., Ernest E. Moore M.D.
1. How often do patients with isolated blunt chest trauma need an emergent operation?
Show answer
Rarely. In patients who arrive in the hospital alive, operative injuries to the pulmonary, vascular, and mediastinal structures are surprisingly rare; only 5% of patients with isolated blunt injury to the chest require thoracotomy.
2. In a patient with a hemothorax after blunt chest injury, what is the most important guide for the decision to operate?
Show answer
The hemodynamic status of the patient. Hemothorax after blunt injury is most often caused by nonoperative lesions of the lung and chest wall. In stable patients, therefore, evacuation of the hemothorax (with a chest tube); reexpansion of the lung, and correction of coagulopathy, hypothermia, and acidosis should be the initial focus. Chest tube output is helpful but is not the principal consideration.
3. What is a tension pneumothorax?
Show answer
Air in the pleural space under pressure caused by a one-way valve mechanism. This can be a life-threatening condition because the increase in intrathoracic pressure decreases venous return, which impaires right ventricular filling, resulting in a decrease in cardiac output.
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Pediatric Trauma
36 PEDIATRIC TRAUMA
David A. Partrick M.D., Denis D. Bensard M.D.
1. What is the leading cause of death in children in the United States?
Show answer
Injuries cause more death and disability in children from ages 1 to 18 years than all other causes combined. Unintentional injury deaths account for 65% of all injury deaths in children under 19 years of age. Each year, approximately 20,000 children and teenagers die as a result of injury and 50,000 children suffer permanent disabilities. Each year, nearly one child in four receives medical treatment for an injury. The estimated annual cost is $15 billion.
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Splenic Trauma
26 SPLENIC TRAUMA
David J. Ciesla M.D., Ernest E. Moore M.D.
1. What is the physiologic role of the spleen?
Show answer
In fetal development, the spleen serves as a major site for hematopoiesis. In early childhood the spleen produces immunoglobulin M (IgM) and tuftsin. The spleen also functions as a filter, allowing resident macrophages to remove abnormal red blood cells (RBCs), cellular debris, and encapsulated and poorly opsonized bacteria.
Abernathy’s Surgical Secrets, Updated Edition (Book w / Student Consult)
Author / s: Harken Alden H., Abernathy Charles, Moore Ernest Eugene
Year: 2004
Pages: 473
Publishers: Elsevier Mosby; 5th Bk & Acc edition
ISBN: 0323034160
