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[Pulmonary embolism as a rare complication of a contusion in the inguinal region].

In the submitted case-history the authors describe the clinical case of an adolescent patient who developed phlebothrombosis of the right ileofemoral area one year after a blunt injury in the scrotal and right inguinal area. The symptoms of pulmonary embolism were detected sooner than the symptoms of phlebothrombosis. Two-dimensional echocardiography provided valuable information when the authors monitored the dynamics of changes in acute cor pulmonale and the effect of administered treatment.

Adolescent↗

[Experimental spinal cord contusion. I. An assessment of the state of the conductivity of different funiculi].

Experiments were conducted on albino rats to study the changes of the amplitude and latency of maxima tract and synaptic components of the dorsal surface potential before and after spinal cord injury at the level of Th9. Dorsal surface potentials were recorded from L4 after stimulation in C2. The amplitude of tract and synaptic component maxima of the short latency potential were found to be considerably reduced after the injury. The latency of both components increased after the injury. The changes of the amplitude or latency of potentials evoked from different stimulated points of the cord were analysed. The possible mechanism of the revealed changes is discussed.

Animals↗

[Compartment syndrome after femoral contusion. Case report and review of the literature].

Compartment syndromes of the lower arm and lower leg are quite well known by now and have been often described in the literature. Those of the upper arm and thigh are rarer and those after pure closed lesion of the soft parts of the thigh are the subject of only sporadic reports in the literature. A recently observed case of this kind prompted the present case report and review of the literature.

Adult↗

[Knee contusion with an interesting incidental finding].

During examination of a 42 year old male patient from Mauretania with an injured knee in the emergency ward, a dracunculiasis - Guinea worm disease - was incidentally diagnosed. As travelling is generally increasing, this disease might be encountered more frequently also in Europe.

Adult↗

[A case of severe posterior hepatic lesion caused by contusion trauma].

A case of blunt liver trauma with massive peritoneal hemorrhage due to a major intraparenchymal injury with active bleeding from a posterior tributary of the right hepatic vein is reported. The treatment consisted of resectional debridement of the VII and VI segment of Couinaud and hemostasis was possible in total vascular exclusion without an intracaval shunt.

Accidents, Traffic↗

[Contusion of the abdominal aorta and massive embolization from the use of a seat belt. A clinical case].

Abdominal aortic lesion following blunt abdominal trauma is infrequent. Parmley quotes 347 cases of aortic lesion among 8710 necropsies. Of these, only 4.6% involved the abdominal aorta. Probably less than 100 cases have been reported afterwards. We report a case associated to the use of safety belt, who developed the serious complication of massive embolization.

Accidents, Traffic↗

[Contusions of the liver in adults. Initial non-operative management with computerized tomography follow-up is a reasonable therapeutic option. Report of 16 cases].

Nonoperative management of blunt liver injury in adults still remains controversial. From February 1985 through September 1989, 27 patients were treated for blunt hepatic trauma: 11 required immediate operation and 16 (59%) were initially managed nonoperatively after evaluation of intraabdominal injury by computerized tomography. All of these 16 patients were hemodynamically stable and had no significant peritoneal signs. CT criteria for nonoperative management included subcapsular and intrahepatic hematoma, capsular tear or unilobar fracture, absence of large hemoperitoneum, absence of large devitalized liver and absence of other intraabdominal organ injuries. Clinical follow-up, repeated radiologic examinations and surgery confirmed the accuracy of CT. Only 2 patients required delayed operation (12.5%). Serial abdominal CT studies are an integral part of the conservative treatment of blunt hepatic injuries and showed complete resolution of hepatic injuries in the fourteen nonoperated patients in less than six months. No death and no delayed septic or biliary complications were noted. Mean hospital stay was seventeen days for all of the patients (multiple injuries or not) and only ten days for isolated blunt liver injury. These good results depend on identification of candidates for nonoperative management on strict clinical and CT criteria. Nonoperative management of adult blunt liver injury based on these findings is a useful alternative in a selected group of hemodynamically stable patients and decreases the rate of non-therapeutic coeliotomy.

Adult↗

[Duodenopancreatic contusions. Diagnostic difficulties in children].

The authors describe a case of duodenopancreatic injury in a 6-year-old girl, with the clinical presentation of appendicitis. The findings point to the importance of a precise anamnesis, as in its mild form the traumatism is often poorly recognized, and may be incorrectly diagnosed. It is therefore recommended that a thorough clinical examination be carried out, with abdominal ultrasonography, X-ray barium and tomodensitometry if necessary. Frequently, as is the case with other abdominal, injuries, surgery may be avoided if the patient's condition is carefully followed.

Child↗