Azygos Vein ; injuries ; Humans ; Male ; Middle Aged ; Thoracic Injuries ; complications ; Wounds, Nonpenetrating ; complications

A 55-year-old male patient suffered from severe high-voltage electric burn with an area of 20%TBSA full-thickness injury. The injury involved the distal end of left upper limb, right trunk, and whole abdominal wall. Fracture of the 7th-10th ribs was found in the right side of chest, with perforation of abdominal cavity, and bilateral pleural effusion was found. Part of the small intestine was necrotic and exposed. At the early stage, xeno-acellular dermal matrix was grafted after debridement of abdominal wound; peritoneal lavage was performed; negative pressure drainage was performed in orificium fistula of intestine for promoting the adhesion between perforated intestine and abdominal scar. Two orificium fistulas formed after closure of abdominal granulation wound by autologous skin grafting. Eschar of chest wall and denatured ribs were retained. The risk of infection of thoracic cavity was decreased by promoting the adhesion between lung tissue and chest wall. During the treatment, the patient was diagnosed with Henoch-Schonlein purpura nephritis by renal biopsy, with the symptoms of purpura in the lower limbs, heavy proteinuria, severe hypoalbuminemia, edema, etc. After control of kidney damage by immunosuppressive treatment instead of glucocorticoid, alleviation of the levels of proteinuria and blood albumin, free latissimus dorsi myocutaneous flap was excised to repair chest wall, and free skin graft was excised to repair intestinal fistula. After all the wounds were successfully covered, the patient was treated with glucocorticoid combined with immunosuppressants for more than 1 year. The patient was followed up for 3 years, and his renal function was completely recovered with satisfactory clinical outcome.
Abdominal Cavity ; Abdominal Injuries ; complications ; surgery ; Burns, Electric ; complications ; surgery ; Humans ; Male ; Middle Aged ; Nephritis ; complications ; surgery ; Purpura, Schoenlein-Henoch ; complications ; surgery ; Thoracic Cavity ; Thoracic Injuries ; complications ; surgery

Persistent vegetative state (PVS) is described as one of the complications of brain damage in the current forensic science literatures. PVS unrelated to brain damage, however, is not uncommon in daily forensic practice. Currently, only "Assessment for Body Impairment of the Injured in Road Traffic Accident" designates PVS as one of its items under the section of "Brain, Spinal Cord, and Nerves Injury." Therefore, it is difficult to assess the damage and disability in PVS, especially PVS due to non-brain damage. Based on a case of PVS caused by chest injury in combination with relevant literature review, this paper provides a summary on the general information, etiology, pathogenesis, clinical manifestation, diagnosis and differential diagnosis of PVS, as well as a guideline for its forensic assessment.
Adolescent ; Back Injuries/complications* ; Forensic Medicine ; Humans ; Male ; Multiple Trauma/complications* ; Persistent Vegetative State/etiology* ; Thoracic Injuries/complications*

Type 2 manubriosternal dislocations with concomitant spinal fracture are rare and may be associated with thoracic visceral injuries. The complication of delayed haemothorax has not been reported yet. We report a case of a young male who suffered manubriosternal dislocation with chance type thoracic spine fracture due to fall of a tree branch over his back. The haemothorax presented late on day three. The possible injury mechanism is discussed along with review of literature. We conclude that a lateral chest radiograph is indicated in spinal fracture patients complaining of midsternal pain. Computerized axial tomography scan of chest with contrast is indicated to rule out visceral injuries and a chest radiograph should be repeated before the patient is discharged to look for delayed haemothorax.
Adult ; Hemothorax ; etiology ; Humans ; Joint Dislocations ; complications ; diagnostic imaging ; Male ; Manubrium ; injuries ; Radiography, Thoracic ; Spinal Fractures ; complications ; diagnostic imaging ; Sternum ; injuries ; Thoracic Vertebrae ; injuries

Thoracic splenosis is the autotransplantation of splenic tissue in the left thoracic cavity as a result of a splenic injury. This rare pathology is usually asymptomatic and may be discovered on incidental imaging, but the diagnosis often requires invasive procedures such as surgery in order to eliminate a neoplasic origin. We report a rare symptomatic case of a 39-year-old man presenting with chest pain and multiple nodules revealed on a computed tomography scan. The patient underwent a surgical exploration and the pathological studies concluded to a thoracic splenosis. Indeed, the previous medical history of the patient revealed a left thoraco-abdominal traumatism during childhood. The aim of this paper is to emphasize that the diagnosis can now be performed using only imaging techniques such as technetium-99 sulfur colloid or labelled heat-denatured red blood cell scintigraphy to avoid unnecessary invasive procedures including thoracotomy.
Abdominal Injuries ; complications ; Adult ; Asymptomatic Diseases ; Humans ; Male ; Spleen ; injuries ; Splenectomy ; Splenosis ; diagnosis ; etiology ; pathology ; surgery ; Thoracic Diseases ; diagnosis ; etiology ; pathology ; surgery ; Thoracic Injuries ; complications ; Thoracotomy ; Unnecessary Procedures

Foreign Bodies ; complications ; Humans ; Neck Injuries ; etiology ; Thoracic Injuries ; etiology ; Wood ; Wounds, Penetrating ; etiology

Adolescent ; Heart Ventricles ; injuries ; Humans ; Male ; Thoracic Injuries ; complications ; Ultrasonography ; Ventricular Septal Rupture ; diagnostic imaging ; etiology ; surgery ; Wounds, Nonpenetrating ; complications

OBJECTIVETo analyze the reliability of magnetic resonance imaging (MRI) in detecting posterior ligament complex injury in thoracolumbar fractures.

METHODSNinety-five patients with thoracolumbar fracture were evaluated by palpation of the inter-spinal gap, plain radiography, and MRI before operation. In addition to conventional MRI sequences, a fat-suppressed T2-weighted sagittal sequence was performed. Surgery was performed by a posterior approach. During the operation, posterior ligament complex was examined.

RESULTSA wide inter-spinal gap was palpated in 41 patients and was found in 55 patients on plain radiography. According to MRI, injury to the supraspinal ligament was suspected in 85 patients, the inter-spinal ligament in 83 patients, and the ligamentum flavum in 26 patients. There were 82 supraspinal ligament injuries, 80 inter-spinal ligament injuries, and 20 ligamentum flavum injuries in operative findings. The relations between plain radiography and operative findings, between MRI interpretation and operative findings were statistically significant.

CONCLUSIONA fat-suppressed T2-weighted sagittal sequence of MRI is a highly sensitive, specific, and accurate method to detect posterior ligament complex injury and which is recommended for the accurate evaluation of posterior ligament complex injury in thoracolumbar fractures.

Adult ; Female ; Humans ; Joint Capsule ; injuries ; Ligaments, Articular ; injuries ; Lumbar Vertebrae ; injuries ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Soft Tissue Injuries ; diagnosis ; Spinal Fractures ; complications ; Thoracic Vertebrae ; injuries

Humans ; Thoracic Injuries ; complications ; pathology ; Trauma Severity Indices ; Wounds, Nonpenetrating ; diagnosis ; etiology ; therapy

Adult ; Hematoma, Epidural, Spinal ; etiology ; Humans ; Male ; Spinal Fractures ; complications ; surgery ; Thoracic Vertebrae ; injuries ; surgery