Left ventricular pseudoaneurysm is a rare complication of myocardial infarction or cardiac trauma. We report a case of sudden death from rupture of such a lesion. Clinically, these lesions need to be distinguished from the other ventricular out-pouching lesions (true aneurysms and diverticula) because of their greater likelihood for rupture. Pathologically, apart from often being infarct-related, they are characterized by a narrow connection with the ventricular cavity and a fibrous outer wall that is devoid of myocardial tissue.
Lesion, NOS ; Left ; seconds ; Traumatic Rupture ; Case Report

A case of spontaneous rupture of uterine artery in the second trimester of pregnancy is described. Haemorrhage from rupture of uterine artery during pregnancy was discovered at laparotomy. This was an unusual but serious complication of pregnancy. This condition is extremely rare and one must consider it in cases of incomprehensible abdominal pain with or without haemodynamic collapse. A review of the literature revealed only four similar cases so far. This pregnancy continued till 37 weeks pregnancy and had a spontaneous vaginal delivery. Immediate institution of effective resuscitative measures and early surgical intervention were essential to both foetal and maternal survival.
Pregnancy ; Pregnancy Trimester, Second ; Hemorrhage ; Uterine artery ; Traumatic Rupture

Traumatic rupture of the diaphragm is uncommon, occurring in 5.3% of cases where blunt trauma to the aMomen required laparotomy and in less than 196 of cases of blunt chest trauma. It is not found in the immediate postinjury phase in 33% to 67% of cases. This eventurates in delayed manifestations, ususally involving herniation of abdominal contents into the chest. We report our experience of the anesthetic management in a patient with old traumatic diaphragmatic hernia for orthopaedic surgery. Following epidural anesthesia, tracheal intubation was done and anesthesia was maintained with isoflurane, narcotics and O2. A careful monitoring was done for adequate oxygenation and ventilation. One month after operation he was transferred to the other hospital for recurred diaphragmatic hemia.
Anesthesia ; Anesthesia, Epidural ; Diaphragm ; Hernia, Diaphragmatic, Traumatic* ; Humans ; Intubation ; Isoflurane ; Laparotomy ; Narcotics ; Oxygen ; Rupture ; Thorax ; Ventilation

Traumatic diaphragmatic injuries in infants and children are uncommon. Late presentation of such an injury is well recognised in adults but is exceptionally rare in children. Because of the increased compliance of the thoracic cage in children, rupture of the diaphragm can occur without signs of external injury. Morbidity and mortality can be minimized by a high index of suspicion, prompt recognition, and surgical repair of even the smallest diaphragmatic injury. We present a case of delayed presentation of traumatic diagphragmatic hernia in a boy of 10 months.
Adult ; Child* ; Compliance ; Diaphragm ; Hernia ; Hernia, Diaphragmatic, Traumatic* ; Humans ; Infant ; Male ; Mortality ; Rupture

Between January 1976 and March 1997, six patients with delayed presentation of traumatic diaphragmatic hernia occured among the 52 patients of traumatic diaphragm rupture, of whom four males and two females, five by blunt trauma and one by stab wound, one was right side and the rest were left side. In all patients, reduction of herniated organs was accomplished by thoracotomy or thoracotomy with extension to abdomen. Suspicion of the diaphragmatic ruture from the acute traumatic chest injured patient is important and we can use the videothoracoscopy for evaluation and treatment of the traumatic diaphragm rupture.
Abdomen ; Diaphragm ; Female ; Hernia ; Hernia, Diaphragmatic, Traumatic* ; Humans ; Male ; Rupture ; Thoracotomy ; Thorax ; Wounds, Stab

Two patients with traumatic aneurysm were children below 10 years and the aneurysmal sac located at the peripheral branch o f the anterior cerebral artey. One of the traumatic aneurysm had been found by rupture of aneurysmal sac during medical treatment under the impression of traumatic cerebral hemorrhage. The other had been found during disabiliy evaluation with unruptured status. In the latter case, traumatic aneurysm was suspected by the small sized enhancing lesion below the falx cerebri in Brain CT scan and confirmed by transfemoral carotid angiography. We clipped neck of these traumatic aneurysm successfully. So. we report these two cases of traumatic aneurysms with review of the literatures.
Aneurysm* ; Angiography ; Arteries* ; Brain ; Cerebral Hemorrhage, Traumatic ; Child ; Humans ; Neck ; Rupture ; Tomography, X-Ray Computed

Traumatic subarachnoid hemorrhage (tSAH) can be almost immediately fatal. However, sudden death due to tSAH caused by delayed aneurysmal rupture is very rare sequela of mild head trauma. We experienced a death case of a 47-year-old woman who had subarachnoid hemorrhage and intraventricular hemorrhage 3 days after head trauma. Delayed death after any kinds of trauma is important to forensic and legal aspects. Herein we report a case of fatal subarachnoid hemorrhage caused by delayed rupture of traumatic aneurysm.
Aneurysm ; Craniocerebral Trauma ; Death, Sudden ; Female ; Head ; Hemorrhage ; Humans ; Jurisprudence ; Middle Aged ; Rupture ; Subarachnoid Hemorrhage ; Subarachnoid Hemorrhage, Traumatic

Traumatic subarachnoid hemorrhage (T-SAH) is said to be typically occurred in a young, healthy, but intoxicated man who receives a minor blow, immediately collapses, and dies within minutes. Sixteen forensic cases of T-SAH were analysed in the point of time of collapse, blood alcohol level, injured site, vascular rupture sites, and sentenced servitude. Majority of the cases (12 cases) were autopsied in the department of Kyungpook National University. Two cases of National Institute of Scientific Investigation, South District Office and 1 case of Jeju National University were added. Autopsy was not done in one case. There were 14 male and 2 female victims. The peak age were their forties (7 cases) and under twenties (7 cases). The time of incident was most often at night. The survival time from the time of trauma until death indicates that 62.5% (10 victims) died immediately from the assault, 12.5% (2 victims) died within 30 minutes. Blood alcohol was detected in 11 cases (68.8%), and mean blood alcohol level was 0.16% (0.08-0.22%). The damage was generated to the facial region, especially around the jaw and below the ears (7 cases), and temporal areas (4 cases). Bleeding foci were detected in 7 cases; basilar artery (2 cases), left vertebral artery (2 cases), and right vertebral artery (3 cases). Meticulous autopsy techniques for identifying the vascular rupture sites are required. The author conclude that tremendous emphasis must be placed on the fact that fatal T-SAH can occur due to minor facial trauma and social campaign for alerting people to the danger of T-SAH is needed.
Autopsy ; Basilar Artery ; Death, Sudden ; Ear ; Female ; Gyeongsangbuk-do ; Hemorrhage ; Humans ; Jaw ; Male ; Rupture ; Subarachnoid Hemorrhage, Traumatic* ; Vertebral Artery

PURPOSE: Rupture of pre-existing cerebral aneurysms has occasionally been reported as a cause of traumatic subarachnoid hemorrhage (TSAH) and intraparenchymal hemorrhage (IPH). SAH due to rupture of pre-existing cerebral aneurysm is an important differential diagnosis in TSAH. The aim of our study was to determine whether a rupture in a pre-existing cerebral aneurysm could be predicted based on the pattern of hemorrhage on the initial computed tomography (CT) scan in patients with traumatic brain injury (TBI). METHODS: A total of 336 patients who had undergone computed tomography angiography (CTA) for detection of rupture of pre-existing cerebral aneurysm in TBI between the years 2004 and 2013 were retrospectively studied. In order to investigate CT findings of ruptured cerebral aneurysm, patients who had a lesion of SAH, IPH, or IVH were compared with the control group (who had intracranial lesions of contusion, epidural hematoma, subdural hematoma, or hemorrhagic contusion). RESULTS: Fifty eight (17.3%) patients with TSAH harbored cerebral aneurysms, and 45 (13.4%) patients had ruptured cerebral aneurysms. The ruptured aneurysms showed significant association with CT findings of a diffuse hemorrhage in the basal cisterns (29.2%, p=0.003, OR=23.130), unilateral sylvian fissure (13.8%, p=0.039, OR=8.842), anterior interhemispheric fissure (20.0%, p=0.028, OR=14.000), and associated IPH (22.6%, p=0.011, OR=16.333). However, the ruptured aneurysms did not show association with CT findings of hemorrhage on convexities, perimesencephalic cisterns, bilateral sylvian fissure, and IVH (p>0.1). CONCLUSION: Patterns of distribution of SAH and associated IPH on initial CT can be predicted of rupture pre-existing cerebral aneurysm in patients with TBI.
Aneurysm, Ruptured ; Angiography ; Brain Injuries* ; Contusions ; Diagnosis, Differential ; Hematoma ; Hematoma, Subdural ; Hemorrhage ; Humans ; Intracranial Aneurysm* ; Retrospective Studies ; Rupture* ; Subarachnoid Hemorrhage ; Subarachnoid Hemorrhage, Traumatic

PURPOSE: Rupture of pre-existing cerebral aneurysms has been reported as a cause of traumatic subarachnoid hemorrhage (TSAH). SAH due to rupture of pre-existing cerebral aneurysm is an important differential diagnosis in TSAH. Our study was aimed to assess whether a rupture in a pre-existing cerebral aneurysm could be predicted on the basis of the quantity and distribution pattern of hemorrhage on the initial computed tomography (CT). METHODS: 197 patients with TSAH were retrospectively studied between the years 2003 and 2008. We examined the age and sex of patients, mechanisms of injury, consciousness level at admission, and CT parameters including the distribution and quantity of SAH, localized blood clot, intraventricular hemorrhage, or hemorrhagic contusion and extra-axial hematoma. We compared the patients with nonaneurysmal TSAH to the patients with aneurysmal TSAH. RESULTS: 22(11.2%) patients with TSAH harbored pre-existing cerebral saccular aneurysms. The aneurysms were found in the patients with diffuse or anteriorly located blood in the basal cisterns(40.6%), unilateral sylvian fissure (16.7%), and anterior interhemispheric fissure(18.2%). But the aneurysm was not found in all patients with perimesencephalic hemorrhage, bilateral sylvian fissures, and convexities. TSAH with localized clot in the anterior interhemispheric or sylvian fissure (OR=5.924, p=0.005), or SAH completely filling any cistern or fissure (OR=3.148, p=0.034) was significantly associated with rupture of pre-existing cerebral aneurysm in logistic regression analysis. CONCLUSION: SAH in the basal cisterns extended into bilateral sylvian fissures and anterior interhemispheric fissure, and SAH in the unilteral sylvian fissure on initial CT could be predicted rupture of pre-existing cerebral aneurysm.
Aneurysm ; Consciousness ; Contusions ; Craniocerebral Trauma ; Diagnosis, Differential ; Head ; Hematoma ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Logistic Models ; Retrospective Studies ; Rupture ; Subarachnoid Hemorrhage ; Subarachnoid Hemorrhage, Traumatic ; Tomography, X-Ray Computed