Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “STRANGULATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMed2001

Frequency and relationship of reported symptomology in victims of intimate partner violence: the effect of multiple strangulation attacks.

The objective of this study is to examine the correlation between the number of times a victim of intimate partner violence (IPV) has been strangled and symptom development subsequent to the attacks. One hundred and one female subjects responded to a series of questions regarding the history and characteristics of the strangulation and the development of specific medical symptoms. Multiple strangulation victims, individuals who had experienced more than one strangulation attack, on separate occasions, by the same abuser, reported neck and throat injuries, neurologic disorders, and psychological disorders with increased frequency. Despite the increased frequency of symptoms, only 39% of the multiple strangulation victims sought medical care. These observations strongly support the need for health care professionals to inquire about the incidence of strangulation, examine the victim closely for evidence of injuries caused by the attacks, and recommend immediate care in anticipation of the potentially long term medical needs.

Adult↗
PubMedDate not supplied

CT analysis of intestinal obstruction due to adhesions: early detection of strangulation.

We evaluated the CT of intestinal obstruction due to adhesions in 20 postoperative patients, with emphasis on early detection of strangulation. Ten patients with surgically proven strangulated obstruction (strangulation group) were compared with another ten patients (nonstrangulation group) in whom seven improved with conservative management and three had confirmed simple obstruction on surgical exploration. Beak-like luminal narrowing ("beak") was the most common CT finding at the obstructed site in both groups. The CT findings that suggested strangulated obstruction were serrated beaks, mesenteric edema or vascular engorgement, and moderate to severe bowel wall thickening. In contrast, simple obstruction could be assumed when the beak was smooth, there were no mesenteric changes, and the bowel wall was normal or mildly thickened. Computed tomography is a useful tool for detecting strangulation in patients with postoperative adhesive intestinal obstruction.

Adolescent↗
PubMed1970

Intestinal Strangulation in Escherichia coli-Monocontaminated Gnotobiotic Rats.

The natural course of ischemic and hemorrhagic intestinal strangulation in previously germ-free rats individually monocontaminated with one of five separate strains of Escherichia coli was investigated. In addition, the effect of intraintestinal homologous heparinized blood upon the course of ischemic intestinal strangulation in E. coli-monocontaminated rats was studied. It was found that (i) E. coli could be an important lethal factor in ischemic and hemorrhagic intestinal strangulation, (ii) hemorrhagic was more deadly than ischemic strangulation, (iii) intra-intestinal blood did not augment the action of the E. coli in these experiments, and (iv) some strains of E. coli were more toxic than others in the presence of intestinal strangulation.

Journal Article↗
PubMed1997

Differentiation of simple and strangulated small-bowel obstructions: usefulness of known CT criteria.

PURPOSE: To evaluate the usefulness of known computed tomographic (CT) criteria for the differentiation of simple and strangulated small-bowel obstructions. MATERIALS AND METHODS: CT scans of 84 patients with simple (n = 43) and strangulated (n = 41) small-bowel obstructions caused by adhesions, hernia, and volvulus were reviewed retrospectively. Diagnoses were made with surgery (n = 55) and during clinical follow-up (n = 29). CT criteria evaluated were configuration of obstructed bowel loop, target sign, bowel wall thickening and enhancement, changes in mesentery and mesenteric vasculature, and amount and attenuation of ascites. RESULTS: CT findings that enabled the detection of strangulated obstructions were poor or no enhancement of bowel wall (sensitivity, 34%; specificity, 100%) and a serrated beak (sensitivity, 32%; specificity, 100%). When these two findings were excluded from analysis, a large amount of ascites, an unusual course of mesenteric vasculature, and diffuse engorgement of mesenteric vasculature were shown to be useful CT findings for performing multivariate regression analysis. Application of these five CT findings enabled identification of 35 (85%) of 41 patients with strangulated obstructions. CONCLUSION: Detecting a combination of selected, known CT criteria increases the diagnostic accuracy of CT to enable differentiation of simple and strangulated small-bowel obstructions.

Contrast Media↗
PubMed2000

A triad of laryngeal hemorrhages in strangulation: a report of eight cases.

The results of histological studies on larynges from eight cases of manual strangulation, all that had intracartilaginous laryngeal hemorrhages, a recently described and under-recognized lesion associated with strangulation, are reported. Formalin-fixed larynges were examined in serial section using a standardized protocol. In all cases, intracartilaginous laryngeal hemorrhages were associated with subepithelial laryngeal hemorrhages, and intralaryngeal muscular hemorrhages forming a "triad of hemorrhages." In five cases, the triad was found in the presence of laryngeal cartilage microfractures. Since cartilage microfractures can be causally related to mechanical injury to the neck, it is likely that the triad of hemorrhages has diagnostic value as an independent morphological criterion for the postmortem diagnosis of strangulation. Since a proportion of cases of strangulation lack characteristics that are self-evidently due to violent application of pressure on the neck, recognition of the triad may have important implications for the postmortem diagnosis of strangulation.

Adult↗
PubMed2000

Prevention of choking, strangulation, and suffocation in childhood.

Choking, suffocation and strangulation are important causes of unintentional injury and death in young children. Choking on food and toys, suffocation from plastic bags and strangulation from strings on children's items are common causes of mechanical airway obstruction. An effective prevention plan must include education, product labeling, and product and container modification. Health care providers can play an important role in the dissemination of prevention information to caregivers and manufacturers in order to reduce the incidence of these injuries in young children. In the United States, mechanical airway obstruction from choking, suffocation and strangulation is the leading cause of unintentional injury that results in death of children less than 1 year. It ranks fourth as a cause of death in children 1 to 9 years, surpassed only by motor vehicle injuries, drowning/submersion, and fire/burns. Many of these deaths are preventable. Prevention of death from mechanical airway obstruction has long been a concern of health care providers, whose role may involve education of parents, other caregivers and manufacturers about the risks and the prevention of choking, suffocation and strangulation in children. Choking is the interruption of respiration by internal obstruction of the airway, usually by food or small toys in young children. Suffocation is obstruction of the airway from an external object that blocks the nose and mouth, such as a plastic bag. Strangulation also results from external compression of the airway from an object, such as a string that becomes caught around the neck.

Accident Prevention↗
PubMed2003

Strangulation injuries.

Strangulation accounts for 10% of all violent deaths in the United States. Many people who are strangled survive. These survivors may have minimal visible external findings. Because of the slowly compressive nature of the forces involved in strangulation, clinicians should be aware of the potential for significant complications including laryngeal fractures, upper airway edema, and vocal cord immobility. Survivors are most often assaulted during an incident of intimate partner violence or sexual assault, and need to be specifically asked if they were strangled. Many survivors of strangulation will not volunteer this information. Accurate documentation in the medical chart is essential to substantiate a survivor's account of the incident. Medical providers are a significant community resource with the responsibility to provide expert information to patients and other systems working with survivors of strangulation. This case study reviews a strangulation victim who exhibited some classic findings.

Adult↗
PubMedDate not supplied

[Asphyxiation by suffocation and strangulation in children younger than 15 years of age].

OBJECTIVE: Our aim was to describe non-intentional strangulation or suffocation suffered by children under 15 years of age. METHODS: Records from the Medical Examiner's Office showed child death by non-intentional strangulation or suffocation from January 1, 1991 to December 31, 2001. RESULTS: A total of 44 suffocations or non-intentional strangulations were registered. Overall mortality was 3.62/1,000,000 persons-year (27.57/1,000,000 in children < 1 year of age, 1.94/1,000,000 in older children); 63.6% were males. Most frequent mechanisms included neck entrapment between bars 18.2%, facial obstruction by bed clothes 15.9%, being covered by rubble, sand, or garbage 15.9%, strangulation by cord, chain, or strip 11.4%, and strangulation by dress or bed clothes 9.1%. CONCLUSIONS: Nearly all registered deaths could be prevented by education, supervision, or structural modifications. Strategies should also include obligatory standards for manufacturing and for warnings on labels.

Accidents↗
PubMed1989

[Mechanisms of the pulmonary congestion in ligature strangulation (IV)].

The authors determined by radioimmunoassay, spectrophotometry or fibrin plate method the changes of levels of plasma or serum vasomotor (renin, bradykinin, plasmin, lactic acid and ferritin) of guinea-pigs sacrificed by ligature strangulation. This experiment was a part of the studies on the mechanisms of the pulmonary congestion in ligature strangulation. 1) In the ligature strangulation group, significant high levels of plasma renin was observed when compared with the presacrificed group and the beating on occiput group. 2) In both the ligature strangulation group and the beating on occiput group, significant high levels of plasma lactic acid were observed when compared with the presacrificed group. However, between the above-mentioned two groups, there were no significant differences in the levels of this substance. 3) Between the ligature strangulation group and the presacrificed group, there were no significant differences in the levels of plasma bradykinin and plasmin and serum ferritin.

Animals↗
PubMed1982

Isotopic identification of intestinal strangulation.

A small series of eleven dogs prepared with a strangulating segment of jejunum demonstrated that a radionuclide, 99mTc-labelled albumin, concentrates in the lumen and bowel wall of the affected intestinal segment. Modern scanning equipment accurately localized the strangulating loop. This technique has the potential of identifying patients with intestinal obstruction, in whom strangulation is a factor, prior to the development of impaired arterial inflow and frank gangrene. These findings confirmed earlier obstructions that were reported when nuclear scanning instrumentation was less sophisticated. Identification of patients at risk for intestinal strangulation requires a high index of suspicion. Excruciating cramping abdominal pain out of proportion to physical findings, roentgenogram evidence, and laboratory studies should alert the physician to the possibility of intestinal ischemia and closed loop obstruction. Radionuclide scanning in such cases may be of assistance in defining or excluding the diagnosis of a strangulating mechanism. The test is simple, relatively economical, and represents a low risk procedure to patients. It would have no place when the classic physical and laboratory findings of intestinal infarction are present.

Animals↗
PubMed1980

Strangulation in childhood: epidemiology and clinical course.

A review of 233 cases of childhood strangulation was made to determine injury epidemiology. Consistent patterns of injury were observed. Crib and playground equipment strangulations are already the subject of Consumer Product Safety Commission (CPSC) preventative regulations. High chair-, playpen mesh-, pacifier cord-, and clothing-related injuries would be amenable to prevention by improved product safety regulation. The CPSC has been petitioned to remedy the first two of these hazards. Many crib and rope strangulations can only be prevented by direct patient counseling. Although Congress empowered and required the CPSC to recognize and correct unsafe products, its surveillance systems may obscure the very design defects that cause injury. Likewise, political considerations may slow enactment of new design regulations. Physicians who treat childhood accident victims are in a position to recognize hazardous products and lobby for their improvement. Of the 233 cases 38 were further evaluated to delineate the clinical course of childhood strangulation. Victims who fail to resume normal cardiopulmonary function by the time of hospitalization have a poor prognosis for neurologic recovery with current modes of therapy. Improved treatment of hypoxic and ischemic cerebral injury might prevent some of the deaths and handicaps resulting from strangulation.

Accident Prevention↗
PubMed1998

"Hidden" laryngeal injuries in homicidal strangulation: how to detect and interpret these findings.

These studies were designed to demonstrate that the usual method of laryngeal dissection carries a significant risk of overlooking important laryngeal injuries. Formalin-fixed hyoid-larynx complexes were prepared in a prospective forensic study involving 191 cases of homicidal strangulation, 1984 to 1997. The basic steps of the applied method included: complete resection of the thyroid cartilage, a horizontal incision through the cricoid cartilage before opening the larynx dorsally, inspection of the laryngeal joints, and incisions of the laryngeal muscles. Using this procedure allowed us to detect the following injuries, which otherwise would have been destroyed or overlooked: (a) 17 incomplete fractures restricted to the dorsal surfaces of the thyroid laminae and 10 incomplete or non-dislocated fractures of the cricoid cartilage. In 7 cases, such a "hidden" fracture was the only laryngeal injury resulting from neck compression. (b) Extensive laryngeal muscle hemorrhages, especially of the vocal folds, were found in almost half of all cases, more rarely in strangulation by ligature and more frequently in manual strangulation. Gross hemorrhages were the decisive local laryngeal finding in 19 cases. (c) Laryngeal joint injuries (bleedings) were found in 18% to 52% of the different strangulation types. (d) Hemorrhages of the laryngeal mucosa were common findings that occur in about 60% of all cases; only in rare cases do such bleedings have a special diagnostic value. The quantity and significance of findings obtainable from complete preparation clearly document Camps's demand made in 1976 to dispense with the usual laryngeal dissection technique (dorsal scissor incision through the cricoid cartilage), at least in (questionable) strangulation cases.

Asphyxia↗
PubMed1979

Intestinal strangulation in germfree and monocontaminated dogs.

Earlier studies in the germfree rat demonstrated that the common intestinal bacteria vary greatly in their ability to cause death after intestinal strangulation. Some of these experiments were repeated in adult, germfree and monocontaminated beagles. Neither short closed-loop hemorrhagic nor long closed-loop ischemic strangulation killed the germfree dog. Either procedure rapidly killed the dog with a conventional bacterial flora or a dog monocontaminated with Clostridium perfringens. The dogs monocontaminated with Bacteroides fragilis died after several days, whereas Escherichia coli killed only one of three animals. These experiments demonstrate the usefulness of the germfree dog as a unique research subject, confirm our earlier studies on intestinal strangulation in germfree rats, and further emphasize the differing lethal potentials of the intestinal bacteria in intestinal strangulation.

Animals↗
PubMed2005

Strangulated low Spigelian hernia in children: report of two cases.

Low Spigelian hernia (LSH) in children is considered an extreme surgical rarity. This clinically deceptive hernia is difficult to diagnose preoperatively and has a real risk of strangulation. Strangulated LSH may be misdiagnosed as strangulated inguinal hernia. Early recognition and timely surgical repair are important to avoid strangulation.

Diagnosis, Differential↗
PubMed2007

Clinical forensic radiology in strangulation victims: forensic expertise based on magnetic resonance imaging (MRI) findings.

Based on only one objective and several subjective signs, the forensic classification of strangulation incidents concerning their life-threatening quality can be problematic. Reflecting that it is almost impossible to detect internal injuries of the neck with the standard forensic external examination, we examined 14 persons who have survived manual and ligature strangulation or forearm choke holds using MRI technique (1.5-T scanner). Two clinical radiologists evaluated the neck findings independently. The danger to life was evaluated based on the "classical" external findings alone and in addition to the radiological data. We observed hemorrhaging in the subcutaneous fatty tissue of the neck in ten cases. Other frequent findings were hemorrhages of the neck and larynx muscles, the lymph nodes, the pharynx, and larynx soft tissues. Based on the classical forensic strangulation findings with MRI, eight of the cases were declared as life-endangering incidents, four of them without the presence of petechial hemorrhage but with further signs of impaired brain function due to hypoxia. The accuracy of future forensic classification of the danger to life will probably be increased when it is based not only on one objective and several subjective signs but also on the evidence of inner neck injuries. However, further prospective studies including larger cohorts are necessary to clarify the value of the inner neck injuries in the forensic classification of surviving strangulation victims.

Adult↗
PubMed1975

Strangulated diaphragmatic hernia. A clinical study.

Symptoms, signs, and definitions of strangulation and incarceration in diaphragmatic herniation are surveyed, and four patients with strangulated diaphragmatic hernia are reported on. Although the symptoms may be uncharacteristic, the diagnosis is easily made, if kept in mind. X-ray examination of the chest, possibly supplemented by a barium meal, usually indicates the diagnosis. The mortality rate in our series was high, similar to the findings in other series in the literature. Since approximately half of the cases of incarcerated and/or strangulated diaphragmatic hernia are due to overlooked traumatic diaphragmatic rupture, we stress the importance of diagnosing and treating such rupture promptly to reduce the mortality rate. Strangulated diaphragmatic hernia is a clinical entity on the borderline between the fields of thoracic and general surgery. The disorder is often overlooked or improperly treated, possibly because most units have limited experience with this particular phenomenon.

Adult↗
PubMed1981

Use of intraperitoneal xenon- 133 for imaging of intestinal strangulation in small bowel obstruction.

Iintraperitoneal xenon- 133 dissolved in saline solution was evaluated for the detection of early strangulation in a reproducible model of segmental intestinal obstruction in rats and dogs. There was a highly significant delay in externally detected isotope washout from animals with strangulated loops compared with normal, sham operated and simple (nonstrangulated) obstruction control groups. Concentrations of isotope obtained n ischemic intestinal tissue exceeded those previously reported by an order of magnitude. Corresponding anterior abdominal gamma camera images showed marked retention of isotope at 1 hour in the strangulation obstruction groups and the sites of this activity corresponded to the location of the ischemic loops. Blinded readings of these images by nuclear radiologists showed this method to be highly accurate for the detection of strangulation in these animal models. This method should be directly applicable to patients with intestinal obstruction.

Animals↗
PubMed1999

Prevention of accidental childhood strangulation: where is the site of obstruction?

BACKGROUND: Accidental strangulation is a preventable problem with limited scientific understanding in children. Children's clothing and household furniture have the potential to cause strangulation. Localizing the site of obstruction would provide understanding and insight to preventing this unfortunate event. METHODS: While undergoing the application of pressure to the submental and suprahyoid region in eight patients flexible endoscopy was performed to evaluate the location of obstruction. RESULTS: Submental pressure occluded the nasopharynx and oropharynx. Suprahyoid pressure occluded the larynx. CONCLUSIONS: In suspension strangulation, airway obstruction appears to occur at the level of the larynx involving the epiglottis and the arytenoids. Increased knowledge regarding site of airway occlusion may help to decrease the hazard of accidental strangulation.

Accidents, Home↗