Adult ; Aneurysm, Dissecting ; diagnosis ; etiology ; Computed Tomography Angiography ; methods ; Conservative Treatment ; methods ; Coronary Angiography ; methods ; Coronary Vessels ; diagnostic imaging ; pathology ; Electrocardiography ; methods ; Heart Injuries ; complications ; Humans ; Magnetic Resonance Imaging, Cine ; methods ; Male ; Multimodal Imaging ; methods ; Myocardial Infarction ; diagnosis ; etiology ; therapy ; Treatment Outcome ; Wounds, Nonpenetrating ; complications

Adult ; Crohn Disease ; complications ; Female ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; Hemoperitoneum ; diagnosis ; etiology ; Humans ; Wounds, Nonpenetrating ; diagnosis ; etiology

Traumatic injury to the male external genitalia is frequently encountered, but acute traumatic dislocation of the penile structure is extremely rare, with only a few reports found in the literature. We herein report the case of a 21-year-old man who sustained blunt trauma to the pelvis following a motor vehicle accident, and had features suspicious of penile dislocation. With the use of computed tomography and bedside ultrasonography, a diagnosis of penile dislocation was made, which was subsequently confirmed intraoperatively. Immediate surgical intervention via gentle manipulation of the penile tissue back to its native position was performed in order to restore normal anatomy. The exact mechanism of penile dislocation is not known. However, circumferential laceration around the foreskin causing degloving injury of the penis is suggested in our patient.
Accidents, Traffic ; Foreskin ; Humans ; Joint Dislocations ; diagnosis ; Male ; Pelvis ; injuries ; Penis ; diagnostic imaging ; injuries ; Scrotum ; diagnostic imaging ; Tomography, X-Ray Computed ; Ultrasonography ; Wounds, Nonpenetrating ; complications ; Young Adult

Adult ; Delayed Diagnosis ; Female ; Humans ; Male ; Middle Aged ; Thoracic Injuries ; complications ; Tricuspid Valve Insufficiency ; diagnosis ; etiology ; Wounds, Nonpenetrating ; complications

A 23-year-old man presented with abdominal pain after suffering blunt trauma caused by a seatbelt injury. His low platelet count of 137 × 10(9)/L was initially attributed to trauma and his underlying hypersplenism due to glucose-6-phosphate dehydrogenase (G6PD) deficiency. Despite conservative management, his platelet count remained persistently reduced even after his haemoglobin and clotting abnormalities were stabilised. After a week, follow-up imaging revealed an incidental finding of a pseudoaneurysm (measuring 9 mm × 8 mm × 10 mm) adjacent to a splenic laceration. The pseudoaneurysm was successfully closed via transcatheter glue embolisation; 20% of the spleen was also embolised. A week later, the platelet count normalised, and the patient was subsequently discharged. This case highlights the pitfalls in the detection of a delayed occurrence of splenic artery pseudoaneurysm after blunt injury via routine delayed phase computed tomography. While splenomegaly in G6PD may be a predisposing factor for injury, a low platelet count should arouse suspicion of internal haemorrhage rather than hypersplenism.
Abdominal Pain ; diagnosis ; etiology ; Accidents, Traffic ; Aneurysm, False ; diagnostic imaging ; etiology ; therapy ; Embolization, Therapeutic ; methods ; Follow-Up Studies ; Glucosephosphate Dehydrogenase Deficiency ; complications ; diagnosis ; Humans ; Injury Severity Score ; Male ; Rare Diseases ; Risk Assessment ; Seat Belts ; adverse effects ; Splenic Artery ; injuries ; Tomography, X-Ray Computed ; methods ; Treatment Outcome ; Wounds, Nonpenetrating ; complications ; diagnosis ; Young Adult

OBJECTIVE: To explore the organ damage character and complications of blunt trauma in the neck, and the advantage and disadvantage of CT and ultrasound for blunt trauma in the neck. METHOD: The data of 7 neck blunt trauma cases was analyzed. Cricoarytenoid joint reduction, tracheotomy, exploratory surgery of neck were performed respectively for these cases. RESULT: Of the 2 cases with vocal cord paralysis, one had his vocal cords fixed in the the para-median position. one had his vocal cords move freely. 2 cases of epiglottis edema had been cured. Among the 2 cases of thyroid area swelling and congestion, one died from respiratory failure, one was cured. One case died of carotid artery embolism. CONCLUSION Circulation of the head should be noticed as well as keeping respiratory tract clear and anti-shock treatment. Some patient with negative laryngeal examinations might get worse in the following hours, and swelling of the neck, dyspnea, obnubilation may appear in these cases. Dynamic monitoring could be helpful for the diagnosis and treatment of neck blunt trauma.
Adult ; Humans ; Male ; Middle Aged ; Neck Injuries ; complications ; diagnosis ; therapy ; Retrospective Studies ; Wounds, Nonpenetrating ; complications ; diagnosis ; therapy ; Young Adult

A 38-year-old woman developed diffusely distributed opacities with crystalline materials in the laser in situ keratomileusis (LASIK) interface of her eye after she was scratched by a sprig during mountain climbing. No sign of flap displacement was noted. Despite two days of topical and systemic antibiotics therapy, the corneal infiltration with interface opacities persisted. The following day, the distribution of the crystalline materials had rotated in a counterclockwise direction. Flap lifting and foreign body removal using sufficient irrigation were performed. One month after surgery, the patient's postoperative uncorrected visual acuity was 0.8 with cleared interface. No signs of epithelial ingrowth or flap striae were noted. Mild traumatic corneal scratching without flap displacement may threaten the integrity of the LASIK interface. If foreign bodies are suspected to be the cause of inflammation, early flap lifting with irrigation is imperative for successful treatment.
Adult ; Cornea/*injuries/pathology/surgery ; Eye Injuries/*complications/diagnosis/surgery ; Female ; Follow-Up Studies ; Humans ; Keratomileusis, Laser In Situ/*methods ; Myopia/surgery ; *Surgical Flaps ; Surgical Wound Dehiscence/diagnosis/*etiology/surgery ; Wounds, Nonpenetrating/*complications/diagnosis/surgery

Therapeutic paracentesis is considered to be a relatively safe procedure and is performed commonly for the control of massive ascites in patients with liver cirrhosis. The commonest puncture site, approximately 4 or 5 cm medial of left anterior superior iliac spine, can be located across the route of the inferior epigastric artery, which is one of the sites of potential massive bleeding. In a 46-year-old woman with liver cirrhosis and refractory ascites, a huge abdominal wall hematoma developed after therapeutic paracentesis. The patient was not stabilized by conservative treatment, and inferior epigastric artery injury was confirmed on angiography. Angiographic coil embolization of the inferior epigastric artery was conducted, after which the bleeding ceased and the hematoma stopped growing. This case indicates that physicians performing paracentesis should be aware of the possibility of inferior epigastric artery injury and consider early angiographic coil embolization when a life-threatening abdominal wall hematoma develops.
Abdominal Wall ; Angiography ; Ascites/surgery ; Embolization, Therapeutic ; Epigastric Arteries/*injuries ; Female ; Hematoma/*etiology/radiography/therapy ; Humans ; Liver Cirrhosis/*diagnosis ; Middle Aged ; Paracentesis/*adverse effects ; Tomography, X-Ray Computed ; Wounds, Nonpenetrating/complications

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

OBJECTIVE: To evaluate the frequency and relevance of the "sentinel clot" sign on CT for patients with traumatic intraperitoneal bladder rupture in a retrospective study. MATERIALS AND METHODS: During a recent 42-month period, 74 consecutive trauma patients (45 men, 29 women; age range, 12-84 years; mean age, 50.8 years) with gross hematuria were examined by the use of intravenous contrast-enhanced CT of the abdomen and pelvis, followed by retrograde cystography. Contrast-enhanced CT scanning was performed by using a helical CT scanner. CT images were retrospectively reviewed in consensus by two radiologists. The CT findings including the sentinel clot sign, pelvic fracture, traumatic injury to other abdominal viscera, and the degree of intraperitoneal free fluid were assessed and statistically analyzed using the two-tailed x2 test. RESULTS: Twenty of the 74 patients had intraperitoneal bladder rupture. The sentinel clot sign was seen for 16 patients (80%) with intraperitoneal bladder rupture and for four patients (7%) without intraperitoneal bladder rupture (p < 0.001). Pelvic fracture was noted in five patients (25%) with intraperitoneal bladder rupture and in 39 patients (72%) without intraperitoneal bladder rupture (p < 0.001). Intraperitoneal free fluid was found in all patients (100%) with intraperitoneal bladder rupture, irrespective of an associated intraabdominal visceral injury, whereas 19 (35%) of the 54 patients without intraperitoneal bladder rupture had intraperitoneal free fluid (p < 0.001). CONCLUSION: Detection and localization of the sentinel clot sign abutting on the bladder dome may improve the accuracy of CT in the diagnosis of traumatic intraperitoneal bladder rupture, especially when the patients present with gross hematuria.
Abdominal Injuries/diagnosis/etiology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Contrast Media/administration & dosage ; Extravasation of Diagnostic and Therapeutic Materials/diagnosis/etiology ; Female ; Fractures, Bone/diagnosis/etiology ; Hematuria/etiology ; Humans ; Image Processing, Computer-Assisted ; Iohexol/diagnostic use ; Male ; Middle Aged ; Observer Variation ; Pelvic Bones/injuries/radiography ; Predictive Value of Tests ; Radiographic Image Enhancement/methods ; Reproducibility of Results ; Retrospective Studies ; Rupture/diagnosis ; Tomography, Spiral Computed/*methods ; Urinary Bladder/*injuries/*radiography ; Wounds, Nonpenetrating/complications/*diagnosis