Biomedical subjects
Publications and source records attributed to D Kaehr.
A true myxoma is a rare neoplasm, and there has never been a fully documented case of a subungual myxoma. We present another digital myxoma in a previously unreported location, accompanied by a review of the literature. Simple excision of the neoplasm will be curative in most cases.
Injury to the gallbladder following blunt abdominal trauma is an unusual finding at laparotomy, with a reported incidence of less than 2%. Avulsion from the liver and detachment from both the cystic duct and artery is an extremely rare finding. The condition of the patient and the extent of injuries will dictate the procedure performed. In the case presented, total avulsion of the gallbladder was successfully treated with identification and ligation of the cystic duct, and coagulation of small bleeding points, followed by placement of a Penrose drain.
OBJECTIVE: To determine if reamed femoral intramedullary nailing increases the pulmonary complications seen in chest-injured patients. DESIGN: Retrospective review of prospectively collected trauma database data from January 1991 to October 1994. SETTING: Methodist Hospital, Indianapolis, Indiana, Level I Trauma Center. PATIENTS: Group I: Chest-injured patients [chest Abbreviated Injury Score (AIS) > or = 2] without femur or tibia fractures. Group II: Chest-injured patients (chest AIS > or = 2) with femoral reamed intramedullary fixation. Group III: Chest-injured patients (chest AIS > or = 2) with femoral shaft fixation using nonreamed fixation (rush rods, plating, or external fixation). Group IV: Non-chest-injured patients (chest AIS < 2) with femoral reamed intramedullary fixation. MAIN OUTCOME MEASUREMENT/HYPOTHESIS: Reamed femoral intramedullary nailing does not alter pulmonary outcomes, even in chest-injured patients. RESULTS: Groups I and II had a very similar incidence of adult respiratory distress syndrome (ARDS), pneumonia, and number of ventilator days. Group III had a significantly higher incidence of ARDS and number of ventilator days than did Group I or II. Group III did not have a chest AIS score significantly different than Groups I and II. Group II had significantly higher ARDS and more ventilator days than did Group IV when only analyzing raw data. When injury severity was adjusted, there were no significant differences in pulmonary outcomes. CONCLUSION: Reamed intramedullary femoral fixation did not increase pulmonary morbidity in chest-injured patients.