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PubMedDate not supplied

Management of abdominal contusion in polytraumatized children.

Management of abdominal contusion in polytraumatized children is based on the conservative treatment of spleen and liver lesions when it is possible. Ultrasonography and CTScan can give a good evaluation of splenic, liver, pancreas or kidney lesions. In some cases, if the haemodynamic conditions are good, a non-operative treatment may be proposed. We report our experience of conservative management of intra abdominal lesions in children, about 91 cases in ten years.

Abdominal Injuries↗
PubMed1991

[Scrotal contusions].

The author reports 8 cases of serious scrotal contusion, requiring urgent intervention with simple drainage castration or suture of the tunica albuginea. It is desirable to operate with in 6 hours in order to avoid ischaemic disorders of the testicle.

Adult↗
PubMed1991

[Heart contusion as an unusual cause of shock in severe polytrauma].

The reported incidence of myocardial contusion after blunt chest trauma is 7-17%. Only one third of these patients present with significant morbidity. The polytrauma is generally dominated by hypovolemic and traumatic shock. Other causes of hypotension are less common, and may thus be ignored. The standard algorithm of care in multiple trauma care, however, leads to the diagnosis even in these cases, as illustrated by a case of prolonged shock induced by blunt myocardial trauma.

Adult↗
PubMed1977

The effect of macrophage poisoning by silica on experimental pulmonary contusion and its benzo-pyrone treatment.

The effect of poisoning the macrophages with silica on the fine structure of pulmonary contusion was studied in rats. It was found that this causes an increase in the concentration of protein in the interstitial tissue and in the air spaces. It also causes a consequent increase in the amount of interstitial oedema. While the benzo-pyrones normally cause a considerable reduction both in the protein concentrations and in the amount of oedema, they do not act in these ways when the macrophages are poisoned. These results imply that the macrophages normally lyse some of the protein and that this effect is considerably enhanced by the action of the benzo-pyrones.

Animals↗
PubMedDate not supplied

Myocardial contusion. Using the index of suspicion for assessing blunt chest trauma.

The body of literature devoted to the diagnosis and treatment of the patient with myocardial contusion (MC) frequently references the "index of suspicion" to qualify those patients at risk for cardiac embarrassment. Absent from this literature, however, is discussion of the importance of diligent nursing assessment and monitoring of these patients. This article shows the relevance of the index of suspicion to the nursing assessment of patients suspected of myocardial injury from blunt chest trauma.

Adult↗
PubMed1991

The utility of cardiac evaluation in the hemodynamically stable patient with suspected myocardial contusion.

Myocardial contusion following isolated blunt thoracic trauma (BTT) remains a diagnostic and therapeutic dilemma. To identify the presence of cardiac abnormality following BTT, 123 hemodynamically stable patients were prospectively evaluated with serial electrocardiograms (ECG) and cardiac enzymes (total CPK and CPK-MB). Gated cardiac radionuclide angiography (MUGA) scans were performed within 48 hours following admission. Patients included in the study sustained significant thoracic trauma identified by physical findings or mechanism of injury. Sixty-three patients (51%) were identified with either abnormal ECG, or abnormal total CPK, CPK-MB, MUGA scan, or combination of the above. Thirty-seven patients (58.7%) manifested an ECG abnormality defined as ST-segment or T-wave abnormality. Twenty-two patients (34.9%) had total CPK value greater than or equal to 50 International Units (I.U.) or CPK-MB fractions greater than or equal to five per cent. MUGA scan was abnormal (right ventricular ejection fraction less than 40 per cent and/or wall motion abnormality) in 12 patients (19%). Eight patients with MUGA scan abnormality had normal ECG and/or normal total CPK, CPK-MB values. Evaluation of all patients up to six months revealed no mortality, malignant arrhythmias, or cardiac failure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[Retinochoroidal changes in experimental severe ocular contusion].

In rabbit models of severe retinal contusion, the retinal edema at the posterior pole resolved in 2 weeks after trauma, leaving central depigmentation and encircling pigmentation. Electroretinogram was diminished permanently and fluorescein angiography showed leakage and staining. The pathologic changes comprised irreversible disruptions of choroidal capillaries, the outer layer of Bruch membrane, retinal pigment epithelium (RPE) and photoreceptor cells, indicating that the regenerative capacity of choroidal capillaries and RPE cells was limited. Transient edema in the inner retinal layers and erythro-phagocytosis by RPE cells were observed.

Animals↗
PubMed1989

[Surgical treatment of contusive dislocation of the lens].

54 of 60 consecutive cases of contusive lens dislocation (incomplete 45 cases and complete 15 cases) were treated surgically by (1) loop delivery of the lens in 39 cases, (2) double needle fixation (Barraquer's method) in 4 cases, (3) intracapsular cryo- or silicon ball extraction in 5 cases, (4) extracapsular cortical aspiration in 3 cases, and (5) VISC lensectomy and vitrectomy in 3 cases. Surgical treatment is indicated in cases of (1) lens dislocation into the anterior chamber or incarcerated in the pupil; (2) secondary glaucoma induced by pupil block; (3) secondary uveitis; (4) visual impairment due to turbid or eccentric lens; and (5) presence of other complications that require surgical intervention, such as retinal detachment.

Adolescent↗
PubMed1989

[Pulmonary contusions. Anatomo-radiologic aspects].

Simultaneous use of pathologic and microangiographic methods in 47 patients with lung contusions due to a closed chest injury with no parietal lesions differentiated between: early traumatic lesions consisting in alveolocapillary ruptures and hematomas distributed at random throughout both lungs, with immediate disseminated intraalveolar hemorrhage as a result; and secondary lesions, known as "shock lung", which are mainly the result of intraalveolar hemorrhage. All these lesions explain the usual development of various forms of fibrosis, responsible clinically for refractory hypoxia.

Adult↗
PubMed1988

[Functional and morphological characteristics of lung contusion].

Interrelated disturbances of functions of the external ventilation, cardiac activity and hemodynamics in contusion of the lung in experiment are always of a phasic character and are distinctly dependent on the volume of the respiratory parenchyma injury. The most pronounced disturbances of respiration and cardiac activity are observed by the end of the first day and the beginning of the second day after trauma. The decreased activity of the pulmonary surfactant and alteration of permeability of the aerohematic barrier play a substantial part.

Adult↗
PubMed1978

Management of patients with lung contusion.

Pulmonary contusion represents a serious complication of chest trauma. Its management should include adequate oxygen therapy and ventilatory support. Monitoring of the patient's condition should be by repeated measurement of arterial blood gases; use of the Swan-Ganz catheter is seldom necessary. Broad-spectrum antibiotics are generally indicated but cortisone, cardiotonic drugs and diuretics are not usually required.

Contusions↗
PubMed1986

Management of the contused arterial segment.

When a contused arterial segment is found at surgical exploration and interposition graft is required, we propose a method of repair in which the posterior wall is not completely divided. This prevents retraction of the arterial ends and eliminates tension on the anastomosis.

Arteries↗
PubMed1979

Management of lung contusion.

One hundred and thirty-two consecutive patients with lung contusion were admitted during the three-year period of 1972 through 1974. All were treated with early intubation and mechanical ventilation with positive and-expiratory pressure with the postulate that such management would minimize the progression of interstitial edema, and intra-alveolar hemorrhage. If progressive increase in the alveolar/arterial oxygen tension gradient was not observed over the ensuing 24 hours, and in the absence of other non-thoracic indications of continuance of mechanical ventilation, patients were extubated and removed from the ventilator. All other patients were further ventilated and followed by daily chest roentgenograms and blood gas studies. Mean ventilation time was 6.2 days. Progressive hypoxemia and deterioration of pulmonary function were not seen. The incidence of pneumonia and tension pneumothorax was low. Overall mortality was 10.6 per cent. The most common cause of death was brain death. No deaths were the result of hypoxemia.

Adult↗
PubMed1985

[Experiences in the therapy of lung contusions. Retrospective study of 424 patients].

A group of 424 patients diversely injured with a lung contusion was examined on problems of diagnosis and therapy. Additional injuries and the modes of accident were helpful in deciding on early mechanical ventilation. Waiting for a deterioration of blood gas analysis or a positive x-ray proved to be too harmful. These rules together with exclusive application of PEEP-Ventilation correlates with a decrease in lethal outcome from 28.1% in 1974 with a mortality rate of 18.8% of pulmonary insufficiency to 8% in 1983 with a lethality of less than 2% of pulmonary insufficiency.

Adolescent↗
PubMed1985

Intraperitoneal hepatic bile duct fistula following blunt abdominal contusion.

Injuries to intrahepatic biliary ducts rarely cause severe clinical manifestations in context with blunt abdominal trauma. A case with mild symptoms and signs, but slowly developing bile peritonitis due to posttraumatic intraperitoneal hepatic bile duct fistula is described here. A young girl sustained a blunt contusion on the right lower thoracoabdominal region by the handle bar of a bike. A week after the accident ultrasonography revealed fluid under the liver. The patient showed no signs of peritonitis but had occasional shoulder pain. At laparotomy 200 ml of biliary fluid was drained from the subphrenic space, and excoriation was observed on the upper surface of the liver. A second operation was necessary due to continuous bile leakage via the drain in the subphrenic space and a bile-fistula was demonstrated by contrast x-ray examination. A local resection of the liver was performed and the intrahepatic bile duct fistula closed by a ligature. The postoperative course was then uneventful and the patient was symptomfree on examination six months after the accident.

Abdominal Injuries↗
PubMed1977

[Organ preservation in contusion of the kidneys (author's transl)].

The majority of our cases (n = 107) were contusions of the kidneys, they were treated conservatively. If a rupture is to be expected the diagnostic measures should include infusion-urogram and selective arteriography. If a rupture has been proved, the early operation should follow immediately in order to preserve the organ. Treating ruptures of the kidneys conservatively should be an exception.

Abdominal Injuries↗
PubMed1984

[Effect of posttraumatic fluctuations in the oxygen tension value in the arterial blood on the intensity of lipid peroxidation in the lungs, liver and myocardium of rats with a lung contusion].

It has been demonstrated in rat experiments that accumulation of lipid peroxidation products in the lungs, liver and myocardium in the early posttraumatic period of pulmonary contusion (the first week after trauma) is observed during the recovery of oxygen tension is the arterial blood (PaO2) rather than during the period of the appearance of arterial hypoxemia. In the lungs, accumulation of malonic dialdehyde (MDA) occurred together with PaO2 recovery in the myocardium and liver, MDA was recorded to accumulate in the initial period of PaO2 recovery, whereupon the MDA content in the myocardium dropped to the MDA content in the myocardium of intact rats, while that in the liver returned to normal only partially.

Animals↗