Altitude ; Female ; Hematoma, Subdural ; diagnosis ; etiology ; Humans ; Middle Aged

ObjectiveTo investigate the diagnosis and management of penile fracture.

METHODSFrom June 1993 to May 2017, 46 cases of penile fracture were treated in our hospital, averaging 33.5 (25－42) years of age and 3.45 (1－10) hours in duration, of which 41 occurred during sexual intercourse, 4 during masturbation and 1 during prone sleeping, 4 with hematuria, but none with dysuria or urethral bleeding. Hematoma was confined to the penis. Emergency surgical repair was performed for all the patients, 45 under spinal anesthesia and 1 under local anesthesia, 16 by coronal proximal circular incision and the other 30 by local longitudinal incision according to the rupture location on ultrasonogram. The tunica albuginea ruptures averaged 1.31 (0.5－2.5) cm in length, which were sutured in the "8" pattern for 6 cases and with the 3－0 absorbable thread for 18 cases. The skin graft or negative pressure drainage tube was routinely placed, catheters indwelt, and gauze used for early pressure dressing. In the recent few years, elastic bandages were employed for 3－5 days of pressure dressing and antibiotics administered to prevent infection. The stitches and catheter were removed at 7 days after surgery.

RESULTSShort-term postoperative foreskin edema occurred in 14 of the 16 cases of circular degloving incision, but no postoperative complications were observed in any of the cases of local incision. Twenty-eight of the patients completed a long-term follow-up of 49.4 (10－125) months, which revealed good erectile function, painless erection, and satisfactory sexual intercourse.

CONCLUSIONSFor most penile fractures, local longitudinal incision is sufficient for successful repair of the tunica albuginea, with mild injury, no influence on the blood supply or lymph reflux, and a low rate complications. It therefore is obviously advantageous over circular degloving incision except when the cavernous body of urethra is to be explored, which necessitates circular degloving incision below the coronal groove.

Adult ; Coitus ; Edema ; etiology ; Hematoma ; diagnosis ; etiology ; Humans ; Male ; Masturbation ; complications ; Penile Erection ; Penis ; injuries ; Postoperative Complications ; etiology ; Rupture ; diagnosis ; etiology ; surgery ; Surgical Wound ; Ultrasonography ; Urethra ; surgery

20-year-old man presented to our emergency department after he was hit by a forklift. He developed haemorrhagic shock from a subcutaneous haematoma in his left thigh and required monitoring in the surgical intensive care unit. He stabilised with aggressive fluid resuscitation with crystalloids and blood transfusion. The recovery was complicated by an infection of the subcutaneous haematoma. Following open drainage of the infected subcutaneous haematoma, he improved and was discharged. To the best of our knowledge, this is the first reported case of a subcutaneous haematoma causing haemorrhagic shock.
Accidents, Traffic ; Diagnosis, Differential ; Hematoma ; complications ; diagnosis ; Humans ; Male ; Shock, Hemorrhagic ; diagnosis ; etiology ; Soft Tissue Injuries ; complications ; diagnosis ; Young Adult

Hematoma ; diagnosis ; diagnostic imaging ; etiology ; Humans ; Kidney Diseases ; complications ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Ultrasonography

To explore the diagnoses and treatment of hemophilic pseudotumor, one case with hemophilic pseudotumor misdiagnosed and treated by operation, was observed and analyzed. The result showed that the final diagnosis of this case was following: hemophilia A (mild type) and hemophilic pseudotumor with injury of femoral nerve. The final diagnosis was given from inquiring case history and family history additionally, and drawing assistance from laboratory examination and computed tomography. After operation, the patient's wound healed very well through supplying coagulation factors positively. In conclusion, it was important for inquiring case history and family history particularly and thinking highly of laboratory examination to reduce the misdiagnosis and error of therapy for this case. If paying attention to preoperative preparation, the danger of hemorrhage during operation can be reduced and wound after operation can heal more rapidly.
Adult ; Diagnostic Errors ; Femoral Nerve ; pathology ; Hematoma ; diagnosis ; etiology ; Hemophilia A ; complications ; Humans ; Male

Neurofibromatosis type 1 (NF-1) is an autosomal dominant disorder that has three major features: multiple neural tumors, cafe-au-lait spots, and pigmented iris hamartomas (Lisch nodules). The purpose of this case report is to advise physicians of the danger associated with the progression of fast-onset massive hemorrhage to hemodynamic instability, which mandates rapid treatment to prevent the development of a life-threatening condition. A 64-yr-old woman with NF-1 was admitted to the Emergency Department (ED) because of a rapidly growing, 10x5x3 cm-sized mass on the left back area. She had previously undergone surgery for a large subcutaneous hematoma, which had developed on her right back area 30 yr before. She became hemodynamically unstable with hypotension during the next 3 hr after admission to ED. Resuscitation and blood transfusion were done, and the hematoma was surgically removed. The mass presented as a subcutaneous, massive hematoma with pathologic findings of neurofibroma. We report a case of NF-1 that presented as recurrent, massive, subcutaneous hemorrhage on the back region combined with hypovolemic shock.
Diagnosis, Differential ; Female ; Hematoma/etiology/pathology ; Hemorrhage/*etiology/pathology ; Humans ; Middle Aged ; Neurofibromatosis 1/*complications/pathology ; Recurrence ; Skin Diseases/*etiology/pathology ; Tomography, X-Ray Computed

OBJECTIVETo analyze the clinical characteristics and effects of rehabilitation treatment on hemophiliacs with iliopsoas hemorrage.

METHODSThe hemophilia patients with iliopsoas bleeding treated in Peking Union Medical College Hospital between January 2006 to December 2010 were enrolled. The clinical characteristics including symptoms, signs, complications, and rehabilitation treatment were analyzed retrospectively.

RESULTSAll of the forty-one hemophiliacs with iliopsoas bleeding were male, 20 cases wee the left bleeding, 18 the right, and 3 the bilateral. The median median age was 18 (6 - 61) years old(y). The median age of the iliopsoas bleeding for the first time was 17 (6 - 20) y. 34 patients accompanied with femoral nerve injury, 19 of them had secondary knee bleeding on the same side. 20 patents had quadriceps atrophy. Pelvic pseudotumor developed in 2 patients and permanent abnormal posture in 2 patients. The main finding of the ultrasound image was low-echo mass in iliopsoas muscles or inguinal region. 34 patients received rehabilitation therapy for 8 - 12 weeks under the support of factor replacement, complete hematomas absorption in 33 of them, with hip range of motion recovering back to baseline. 27 of 32 (84.4%) cases with femoral nerve injury got quadriceps strength above 4/5 grade, 20 cases of femoral nerve injury (62.5%) still had numbness on front of their thigh after treatment.

CONCLUSIONSIn this cohort of iliopsoas bleeding, most of the patients are adolescent. High prevalence of the femoral nerve injury and the secondary knee bleeding are found. Rehabilitation treatment under the support of factor replacement is safe and effective on hematoma absorption and neurological function recovery.

Adolescent ; Adult ; Child ; Hematoma ; etiology ; rehabilitation ; Hemophilia A ; complications ; rehabilitation ; Hemorrhage ; etiology ; rehabilitation ; Humans ; Male ; Middle Aged ; Muscular Diseases ; diagnosis ; etiology ; rehabilitation ; Psoas Muscles ; physiopathology ; Retrospective Studies ; Young Adult

Factor V deficiency is a rare hereditary disorder. We report a patient with factor V deficiency who presented with menorrhagia and pelvic haematoma. The Haematology Department at the Royal Brisbane Hospital performed the definitive factor assays leading to the diagnosis. The challenges of her management were obtaining adequate supplies of factor V and her socioeconomic circumstances. The main future challenge will be the supervision of her pregnancies.
Blood Coagulation Factors - analysis ; Factor V Deficiency - complications ; Factor V Deficiency - diagnosis ; Female ; Genital Diseases, Female - etiology ; Hematoma - etiology ; Humans ; Menorrhagia - etiology

Traumatic retropharyngeal hematoma is a rare condition and may be lethal in some cases. In patients with this condition, the absence of a vertebral fracture or a major vascular injury is extremely rare. We present the case of a 92-year-old man who hit his forehead by slipping on the floor in his house. He had no symptoms at the time; however, he experienced throat pain and dyspnea at 6 hours after the injury. On arrival, he complained of severe dyspnea; therefore, an emergency endotracheal intubation was performed. A lateral neck roentgenogram after intubation showed dilatation of the retropharyngeal and retrotracheal space and no evidence of a cervical vertebral fracture. Cervical computed tomography (CT) with contrast medium revealed a massive hematoma extending from the retropharyngeal to the superior mediastinal space but no evidence of contrast medium extravasation or a vertebral fracture. However, sagittal magnetic resonance imaging (MRI) revealed an anterior longitudinal ligament (C4-5 levels) injury. We determined that the cause of the hematoma was an anterior longitudinal ligament injury and a minor vascular injury around the injured ligament. Therefore, we recommend that patients with retropharyngeal hematoma undergo sagittal cervical MRI when roentgenography and CT reveal no evidence of injury.
Aged ; Aged, 80 and over ; Hematoma ; diagnosis ; etiology ; Humans ; Longitudinal Ligaments ; injuries ; Magnetic Resonance Imaging ; Male ; Pharyngeal Diseases ; diagnosis ; etiology ; Tomography, X-Ray Computed

Abdominal Wall ; blood supply ; Anticoagulants ; adverse effects ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; Hematoma ; diagnosis ; etiology ; Humans ; Male ; Middle Aged ; Warfarin ; adverse effects