Aged ; Female ; Humans ; Iatrogenic Disease ; Lacerations ; etiology ; Pneumoperitoneum ; etiology ; therapy ; Trachea ; injuries ; Tracheostomy ; adverse effects ; instrumentation ; Treatment Outcome

OBJECTIVE: To investigate the perinatal outcome and risk factors of precipitate labor in term primipara. METHODS: A total of 6951 full-term singleton primiparas with cephalic vaginal delivery in Women's Hospital, Zhejiang University School of Medicine from January 2020 to December 2020 were enrolled, among whom 381 cases of precipitate labor were classified as the precipitate labor group and 762 cases of normal labor were randomly selected as the control group. The perinatal outcomes of the two groups were compared, and the risk factors of precipitate labor were analyzed by multivariate logistic regression. RESULTS: The incidence of precipitate labor in full-term, singleton pregnancy and cephalic primiparas was 5.48% (381/6951). The durations of the first and second stages of labor in the precipitate labor group were significantly shorter than that in the control group ( P<0.01); while there was no significant difference in the duration of the third stage of labor between the two groups ( P>0.05). Compared with the control group, the incidence of soft birth canal laceration in the precipitate labor group was increased ( P<0.01). However, there was no significant difference in postpartum hemorrhage and neonatal related perinatal outcomes between the two groups (all P>0.05). Multivariate logistic regression analysis showed that maternal height ( OR=1.038, 95% CI: 1.010-1.067, P<0.01), gestational age at delivery ( OR=0.716, 95% CI: 0.618-0.829, P<0.01), late miscarriage ( OR=1.986, 95% CI: 1.065-3.702, P<0.05), membrane rupture before labor ( OR=1.802, 95% CI: 1.350-2.406, P<0.01), labor induction by transcervical balloon ( OR=3.230, 95% CI: 2.027-5.147, P<0.01), labor induction by propess ( OR=2.332, 95% CI: 1.632-3.334, P<0.01) and labor induction by oxytocin ( OR=0.291, 95% CI: 0.219-0.386, P<0.01) were independently associated with precipitate labor. CONCLUSIONS The incidence of precipitate labor in full-term, singleton pregnancy was not low. Precipitate labor could lead to a significant increase in perineal laceration. Maternal height, history of late miscarriage, membrane rupture before labor and labor induction by transcervical balloon, labor induction by propess are risk factors, while labor induction by oxytocin and late gestational time of delivery are protective factors for precipitate labor in term primipara.
Infant, Newborn ; Pregnancy ; Female ; Humans ; Oxytocin ; Abortion, Spontaneous ; Lacerations/etiology* ; Labor, Induced/adverse effects* ; Risk Factors ; Retrospective Studies

Vascular injuries in lumbar disc surgery are serious complications which may be overlooked due to a broad range of clinical manifestations. It is important to be aware of the perioperative implications of this rare occurrence to lower mortality risk. A 20-yr-old man with a right L4-5 lumbar disc protrusion was operated on routinely under a surgical microscope. A bloody surgical field was noted temporarily during a discectomy along with a decreased blood pressure. After fluid resuscitation with an ephedrine injection, the bleeding soon stopped spontaneously and his vital signs were stabilized. Fifty hours after the operation, the patient showed signs of hypovolemic hypotension with abdominal distension. The right femoral artery pulsation was absent on palpation. An enhanced CT angiography revealed a retroperitoneal hematoma and obstruction of the left common iliac artery. An urgent laparotomy was done to repair the injured vessel by excision and interposition of a graft. The patient had an uneventful recovery.The subacute course of deterioration might have been due to intermittent blood leakage from the lacerated common iliac artery, which was sealed spontaneously. It is very important to pay close attention to post-surgical clinical manifestations to avoid a potentially fatal outcome in lumbar disc surgery.
Angiography ; Diskectomy/*adverse effects ; Hematoma/etiology ; Humans ; Iliac Artery/*injuries ; Intervertebral Disc ; Lacerations/*etiology ; Lumbar Vertebrae/*surgery ; Male ; Tomography, X-Ray Computed ; Young Adult

Colonoscopic examination is a safe procedure, however, unexpected complications can sometimes occur. Bleeding and perforation of the colon have been reported as the most common complications. Hemoperitoneum after colonoscopy is an unusual complication, but it may be catastrophic. We report on a 20-year-old man who experienced left low quadrant pain after undergoing colonoscopy. Hemoperitoneum was diagnosed using abdominal CT. A laparoscopic exploration was urgently performed, revealing a lacerated mesocolon of the descending colon. Bleeding of the injured site was controlled without complication. The patient recovered fully without signs of recurrent bleeding. This report implies that if the patient has persistent abdominal pain after undergoing colonoscopy, we should consider hemoperitoneum as one of the causes. To the best of our knowledge, no case of isolated laceration of the mesocolon of the descending colon after colonoscopy has been reported.
Colonoscopy/adverse effects ; Hemorrhage/etiology ; Humans ; Lacerations/*diagnosis/radiography ; Laparoscopy ; Male ; Mesocolon/blood supply ; Pneumoperitoneum/radiography ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo investigate the clinical effect of Halo-vest head ring in the treatment of replantation of total scalp avulsion.

METHODSWe treated 11 cases of total scalp avulsion with the anastomosis of arteriovenous vessels and Halo-vest head ring from December 2006 to February 2015.

RESULTSOne patient's replanted scalp got necrosis because of serious contusion which was healed without hair growth after free skin graft and dressing. All the scalp flaps in the other 10 patients survived. After 3-96 months follow-up, the wound completely healed, the scalp and hair grew well with satisfactory appearance.

CONCLUSIONSThe use of Halo-vest head ring for replantation of total scalp avulsion can effectively improve the survival rate and survival area.

Anastomosis, Surgical ; methods ; Bandages ; Graft Survival ; Humans ; Lacerations ; surgery ; Necrosis ; etiology ; Prostheses and Implants ; Replantation ; methods ; Scalp ; injuries ; pathology ; surgery ; Skin Transplantation ; methods ; Surgical Flaps

To report on an epithelial inclusion cyst of the iris that was successfully treated with needle aspiration and Ab externo laser photocoagulation. A 6-year-old boy was treated for a 6.0 mm fluid-filled cyst in the anterior chamber of the right eye. Thirteen months previously, he had undergone primary closure of a 6 mm full-thickness corneal laceration. The subsequent cyst was diagnosed as an epithelial inclusion cyst of the iris. His vision decreased to finger-count at 30 cm as the cyst grew over the pupil. We performed needle aspiration of the cyst and Ab externo laser photocoagulation of the cyst wall. The treated lesion was completely removed. The patient's visual acuity recovered to 20/40 without complications. There was no recurrence as determined by slit lamp examination up to 6 months after treatment. Needle aspiration and Ab externo laser photocoagulation can be used to effectively treat epithelial inclusion cysts of the iris.
Biopsy, Fine-Needle ; Child ; Cornea/injuries ; Cysts/etiology/*pathology/surgery ; Epithelial Cells/*pathology ; Eye Injuries, Penetrating/complications/surgery ; Humans ; Iris Diseases/etiology/*pathology/surgery ; Lacerations/complications/surgery ; Laser Coagulation ; Male ; Play and Playthings/injuries

BACKGROUNDObstetric anal sphincter injuries (OASIS) can cause an adverse impact on women's physical and mental health. There was lack of published data in Chinese population particularly on studying the risk of OASIS for nonrotational outlet forceps. This study was to determine the incidence and risk factors of OASIS.

METHODSThis is a retrospective cohort study carried out in a tertiary referral hospital in Hong Kong. The control group was selected randomly. Univariate and multivariate logistic regression analysis was performed to evaluate the influence of potential risk factors on OASIS. This study reviewed the obstetric records of OASIS women and random control from January 2011 to June 2014. Univariate and multivariate logistic regression analysis was performed to evaluate the influence of potential risk factors on OASIS.

RESULTSOf 15,446 women delivered, 49 had OASIS. The percentage of OASIS increased from 0.3% (2011) to 0.38% (2014). There was an increasing trend of OASIS in attempted spontaneous vaginal delivery without episiotomy (P < 0.01), but it did not increase the OASIS risk (P = 0.46). Univariate analysis of 49 cases and 438 control subjects showed that forceps delivery (odds ratio [OR] =8.73, P < 0.01), prolong second stage of labor (OR = 1.43, P < 0.01) increased the risk for OASIS. In multivariate regression models, only forceps delivery (OR = 6.28, P < 0.01) proved to be independent risk factor.

CONCLUSIONSThe incidence of OASIS in Chinese women was increased after 2012, but still lower than the reported figures in the literature. Outlet forceps delivery could be a possible associated risk factor.

Adult ; Anal Canal ; injuries ; Delivery, Obstetric ; adverse effects ; Female ; Hong Kong ; epidemiology ; Humans ; Incidence ; Lacerations ; epidemiology ; etiology ; Multivariate Analysis ; Obstetric Labor Complications ; epidemiology ; etiology ; Pregnancy ; Retrospective Studies ; Risk Factors

We report four unusual cases of upper eyelid retraction following periorbital trauma. Four previously healthy patients were evaluated for unilateral upper eyelid retraction following periorbital trauma. A 31-year-old man (Case 1) and a 24-year-old man (Case 2) presented with left upper eyelid retraction which developed after blow-out fractures, a 44-year-old woman (Case 3) presented with left upper eyelid retraction secondary to a periorbital contusion that occurred one week prior, and a 56-year-old man (Case 4) presented with left upper eyelid retraction that developed 1 month after a lower canalicular laceration was sustained during a traffic accident. The authors performed a thyroid function test and orbital computed tomography (CT) in all cases. Thyroid function was normal in all patients, CT showed an adhesion of the superior rectus muscle and superior oblique muscle in the first case and diffuse thickening of the superior rectus muscle and levator complex in the third case. CT showed no specific findings in the second or fourth cases. Upper eyelid retraction due to superior complex adhesion can be considered one of the complications of periorbital trauma.
Accidents, Traffic ; Adult ; Eye Injuries/*complications/surgery ; Eyelid Diseases/*etiology/radiography ; Female ; Humans ; Lacerations/complications/surgery ; Lacrimal Apparatus/*injuries ; Male ; Middle Aged ; Oculomotor Muscles ; Orbital Fractures/*complications/surgery ; Tomography, X-Ray Computed

Cutaneous pseudolymphoma is an uncommon, benign lymphoproliferative disorder of the skin. Although this condition is most commonly idiopathic, its occurrence has been associated with cosmetic tattoos. We report a unique case of cutaneous pseudolymphoma that occured after accidental, traumatic inoculation of a red pigment in a healthy 33-year-old woman.
Adult ; Betamethasone ; analogs & derivatives ; therapeutic use ; Biopsy ; Coloring Agents ; adverse effects ; Female ; Forehead ; pathology ; Humans ; Lacerations ; Lymphoproliferative Disorders ; diagnosis ; etiology ; Pseudolymphoma ; chemically induced ; diagnosis ; Skin ; pathology ; Skin Diseases ; chemically induced ; diagnosis ; Triamcinolone Acetonide ; therapeutic use