The Experts below are selected from a list of 840 Experts worldwide ranked by ideXlab platform
Muhammed Ashraf Memon - One of the best experts on this subject based on the ideXlab platform.
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Delayed duodenal hematoma and pancreatitis from a Seatbelt Injury.
The western journal of emergency medicine, 2011Co-Authors: Katherine Deambrosis, Manjunath S. Subramanya, Breda Memon, Muhammed Ashraf MemonAbstract:Traumatic duodenal hematoma is a rare condition that is encountered in the paediatric age group following blunt abdominal trauma. It poses both a diagnostic and therapeutic challenge. The main concern is increased morbidity secondary to delayed diagnosis and associated occult injuries to the adjacent structures. Most of these hematomas resolve spontaneously with conservative management, and the prognosis is good. We present a case of a 15-year-old boy who had a delayed presentation of duodenal hematoma and acute pancreatitis, which was treated conservatively with complete resolution.
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PS02P DELAYED PRESENTATION OF DUODENAL HEMATOMA AND ACUTE PANCREATITIS FOLLOWING A Seatbelt Injury
Anz Journal of Surgery, 2009Co-Authors: Manjunath Siddaiah-subramanya, Katherine Deambrosis, Breda Memon, R. Hopkins, Muhammed Ashraf MemonAbstract:Purpose: Intramural duodenal hematoma is a rare duodenal Injury, usually occurring in association with blunt abdominal trauma. Diagnostic and therapeutic implementations remain controversial. We present a case of delayed onset of such an Injury complicated by acute pancreatitis following a MVA. Methodology: A 15-year old male re-presented to the emergency department four days after involvement as a restrained rear seat passenger in a front-on collision at 60 km per hour. In the absence of demonstrable external Injury or clinical signs of trauma, the patient was discharged home following six hours of stable observation. Over the subsequent four days, he developed increasing abdominal distension and pain for which he represented to the hospital. Results: On examination the patient was hypovolaemic and tachycardic with a tense, distended abdomen with few bowel sounds. An abdominal CT demonstrated significant duodenal hematoma. An oral Gastrografin meal study performed six hour later showed complete gastric outlet obstruction. The patient was managed conservatively with a NG aspirations and TPN. He developed high lipase levels a couple of days later suggesting delayed manifestation of pancreatic Injury. A repeat CT scan however was negative. A repeat gastrografin meal on day 18 revealed complete resolution of the gastric outlet obstruction. Conclusion: This case emphasises the characteristic delayed presentation of duodenal hematoma following a blunt abdominal trauma and associated sequelae of delayed pancreatitis. Total parenteral nutrition and gastric decompression provides an effective conservative treatment of gastric outlet obstruction associated with this Injury.
Shlomo Torem - One of the best experts on this subject based on the ideXlab platform.
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Seatbelt Injury to the common iliac artery: report of two cases and review of the literature.
The Journal of Trauma: Injury Infection and Critical Care, 1992Co-Authors: Samy Nitecki, Ron Karmeli, Yehudith Ben-arieh, Alfred Schramek, Shlomo ToremAbstract:Blunt trauma to the common iliac artery is rather rare. Moreover, Seatbelt injuries to the common iliac artery have not yet been reported. This article presents two cases of Seatbelt Injury involving the common iliac artery. A deceleration-type mechanism is suggested as the primary cause of Injury, resulting in the production of an intimal flap. The diagnosis of such an Injury is based on clinical suspicion, a change of pulse, or lower limb ischemia. On arteriotomy the damage is greater than seen on external examination. Once diagnosed prompt treatment should follow to prevent loss of life or limb. The signs, symptoms, and modalities of treatment are reported, as well as a review of the literature.
N Giardino - One of the best experts on this subject based on the ideXlab platform.
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Seatbelt Injury to the common iliac artery: Case report
Journal of Forensic Sciences, 1998Co-Authors: Alessandro Dell'erba, G Di Vella, N GiardinoAbstract:In traffic accident victims, the seat belt syndrome is a well known Injury which rarely involves the common iliac artery due to its posterior anatomical position and to protection by the pelvis. We report a case of blunt abdominal trauma related to the type of seat belt worn. The trauma provoked subintimal haemorrhaging of the left common iliac artery, without skeletal lesions or other visceral injuries. Correct diagnosis was delayed for three months after the crash, when an angiogram was performed to investigate disabling claudication and vascular pulse change in the left leg. This arterial Injury could have been related to the association of two different types of force created during the crash ("compression/deceleration-type mechanism") that might have produced shearing forces causing a vascular wall discontinuity and/or an intimal flap. The authors speculate that the vascular lesion was observed on the same (left) side as the fastening point of the seat belt (a lap-and-shoulder belt with a three-point attachment) where the shearing forces may have been most intense due to the junction between the lap strap and the diagonal shoulder belt.
O. Traynor - One of the best experts on this subject based on the ideXlab platform.
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The “flying” bile duct: avulsion of the common bile duct in a plane crash survivor
Irish Journal of Medical Science, 2008Co-Authors: H. Mohan, D. Beddy, A. Latif, T. Bangash, D. Quill, O. TraynorAbstract:Blunt trauma is an unusual cause of extrahepatic bile duct Injury. This is a case of a 51-year-old gentleman who sustained a significant Seatbelt Injury in a plane crash. Laparotomy, performed due to persistent abdominal pain, revealed that the common bile duct (CBD) was completely avulsed from the duodenum. Following insertion of drains and transfer to a hepatobiliary centre, the devascularised CBD was excised and replaced with a roux-en-y hepaticojejunostomy. Necrotic tissue was debrided from the pancreatic head. A persistent bile leak developed from the sub-hepatic drain. Repeat laparotomy revealed a bile leak from small ducts on the liver surface. Ligation of the ducts and bioglue sealing of the area were successfully performed. Subsequent to this a pancreatic fistula developed from the main pancreatic duct, which has since resolved. This unusual case illustrates the need for prompt recognition and early repair to optimise outcomes in traumatic CBD Injury.
Sengfeng Jeng - One of the best experts on this subject based on the ideXlab platform.
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intra abdominal Seatbelt Injury case report
中華民國急救加護醫學會雜誌, 1995Co-Authors: Poping Liu, Fongfu Chou, Mingsong Chang, Kuanchou Shieh, Sengfeng JengAbstract:The use of the Seatbelt decreases the mortality rate and morbidity of automobile accidents. However, the belt systems have their own unique Injury patterns, and the “Seatbelt syndrome” has become more common. A 35-year-old restrained driver from a car accident was evaluated in our emergency department. 1-us physical examination was non-specific except for the ”Seatbelt sign” The patient underwent a celiotomy about 12 hours after the accident due to peritonitis. A perforation of the distal ileum was found and repaired. The patient had an uneventful recovery. The diagnosis of an intra-abdominal Seatbelt Injury may be difficult to make. Initial physical findings, diagnostic peritoneal lavage, and abdominal computed tomography may not accurately identify patients with intra-abdominal Injury. Clinicians should be suspicious when the ”Seatbelt sign” is present. All such patients should be kept under close observation and the trauma surgeon should be consulted. Delay in diagnosis significantly increases morbidity and mortality.