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Cervantes BYH, Gavor SE, Jiagge NE, Lopez DM, Lambert RG, Almaguer Acevedo FM. Liver impalement with an antique African iron barbed spear. A case report. J Surg Case Rep 2024; 2024:rjae234. [PMID: 38638927 PMCID: PMC11026060 DOI: 10.1093/jscr/rjae234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 03/23/2024] [Indexed: 04/20/2024] Open
Abstract
Impalement injuries happen when an object penetrates a body cavity or organ and remains in situ. We present a case of a 35-year-old fisherman whose act of violence resulted in the lodging of an antique iron spear in segment V of the liver, which was then referred to our institution on the day after the accident. Despite the challenges posed by patient transfer, diagnosis, resuscitation, and, most importantly, handling in the operating room, the object was successfully removed via hepatotomy, and the patient is now in good health. Impalement by an ancient African iron spear, repurposed as a fishing tool in modern times, remains undocumented in the literature, necessitating reporting and a call for further research by the medical community into managing impalement injuries of varying severity.
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Affiliation(s)
- Barbara Y H Cervantes
- Department of Surgery, School of Medicine, University of Health and Allied Sciences, Ho, Sokode, P.O. Box PMB 31, Volta Region, Ghana
| | - Samuel E Gavor
- Department of Surgery, Ho Teaching Hospital, Ho-Denu road, Ho Municipal, P.O. Box MA 374, Volta Region, Ghana
| | - Nuna E Jiagge
- Department of Surgery, Ho Teaching Hospital, Ho-Denu road, Ho Municipal, P.O. Box MA 374, Volta Region, Ghana
| | - Duniesky M Lopez
- Department of Internal Medicine and Therapeutics, School of Medicine, University of Health and Allied Sciences, Ho, Sokode, P.O. Box PMB 31, Volta Region, Ghana
| | - Radisnay G Lambert
- Department of Surgery, School of Medicine, University of Health and Allied Sciences, Ho, Sokode, P.O. Box PMB 31, Volta Region, Ghana
| | - Fernando M Almaguer Acevedo
- Department of Surgery, School of Medicine, University of Health and Allied Sciences, Ho, Sokode, P.O. Box PMB 31, Volta Region, Ghana
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Ząbkowski T, Brzozowski R, Durma AD. Renal injuries in conflict zones: a 6-year study of traumatic cases in Afghanistan. Confl Health 2024; 18:6. [PMID: 38183150 PMCID: PMC10770980 DOI: 10.1186/s13031-023-00566-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/28/2023] [Indexed: 01/07/2024] Open
Abstract
PURPOSE During hostilities, gunshot wounds are the most common cause of penetrating injuries. In 8-10% of abdominal injuries kidneys are involved. The treatment method include surgical or conservative treatment (fluids + blood components). METHODS Of 1266 combat trauma cases treated during 6 to 14 rotation of the Polish Military Contingent in Afghanistan, we extracted a subgroup of 44 kidney injuries. Corelation of trauma mechanism, PATI score, treatment methods, and outcomes was evaluated. RESULTS Out of the 41 renal injuries, 20 considered left, 18 right, and 3 both kidneys. There were no statistical significancy in injury lateralization (p = 0.669), and no differences regarding side of a trauma and quantity of blood component used for the treatment (p = 0.246). Nephrectomy was performed on 17 patients (13 left vs. 4 right). A significant correlation between PATI score and the need for a nephrectomy (p = 0.027) was confirmed. Penetrating trauma recquired higher number of blood components comparing to blunt trauma (p < 0.001). The renal salvage rate was in study group was 61.36%. The overall survival (OS) rate was 90.25% - 4 patients died due to trauma. CONCLUSIONS The damage side does not result in a statistically significant increase in the need for blood transfusions or differences in the PATI score. The mechanism of trauma does, however, affect the number of blood components required for treatment, particularly in cases of penetrating trauma. With the introduction of proper treatment, the overall survival rate exceeds 90%, even when opting for conservative treatment.
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Affiliation(s)
- Tomasz Ząbkowski
- Department of Urology, Miliary Institute of Medicine - National Research Institute, Warsaw, Poland
| | - Robert Brzozowski
- Department of General and Oncological Surgery, 5th Military Clinical Hospital with Polyclinic, Cracov, Poland
| | - Adam Daniel Durma
- Department of Endocrinology and Radioisotope Therapy, Miliary Institute of Medicine - National Research Institute, Warsaw, Poland.
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Dell'Aversana F, Comune R, Scognamiglio M, Grassi F, Durante A, Avallone R, Tonerini M, Affinito P, Tamburro F, Scaglione M. Gunshot vaginal trauma. Radiol Case Rep 2023; 18:4544-4548. [PMID: 37868007 PMCID: PMC10587674 DOI: 10.1016/j.radcr.2023.09.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/24/2023] Open
Abstract
Nonobstetric vaginal or vulva trauma is an extremely rare occurrence, with an incidence of < 0.2% of traumas. CT represents the gold standard in the diagnosis of gunshot lesions due to its ability to detect and stage injuries with very high sensitivity and specificity. A standardized protocol for penetrating trauma is still under debate for the use of intravenous contrast only or also rectal and oral contrast. Herein, we report a case of gunshot vaginal trauma in a 43-year-old patient presenting with vaginal bleeding. In our case, the protocol was "patient's tailored," the intravaginal selective use of air was administered due to symptoms (vaginal bleeding) and CT findings, this 2-step protocol increased diagnostic confidence and allow a correct and challenging diagnosis.
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Affiliation(s)
- Federica Dell'Aversana
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Rosita Comune
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Marco Scognamiglio
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Francesca Grassi
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Adele Durante
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Roberta Avallone
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Michele Tonerini
- Department of Emergency Radiology, Cisanello Hospital, Pisa, Italy
| | - Pietro Affinito
- Division of Radiology, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Fabio Tamburro
- Department of Radiology, Ospedale del Mare-ASL NA1 Centro, Naples, Italy
| | - Mariano Scaglione
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Piazza Università, Sassari, Italy
- Department of Radiology, James Cook University Hospital, Middlesbrough, UK
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Gopireddy DR, Kee-Sampson JW, Vulasala SSR, Stein R, Kumar S, Virarkar M. Imaging of penetrating vascular trauma of the body and extremities secondary to ballistic and stab wounds. J Clin Imaging Sci 2023; 13:1. [PMID: 36751564 PMCID: PMC9899476 DOI: 10.25259/jcis_99_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/20/2022] [Indexed: 01/04/2023] Open
Abstract
In the United States, gunshot wounds (GSWs) have become a critical public health concern with substantial annual morbidity, disability, and mortality. Vascular injuries associated with GSW may pose a clinical challenge to the physicians in the emergency department. Patients demonstrating hard signs require immediate intervention, whereas patients with soft signs can undergo further diagnostic testing for better injury delineation. Although digital subtraction angiography is the gold standard modality to assess vascular injuries, non-invasive techniques such as Doppler ultrasound, computed tomography angiography, and magnetic resonance angiography have evolved as appropriate alternatives. This article discusses penetrating bodily vascular injuries, specifically ballistic and stab wounds, and the corresponding radiological presentations.
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Affiliation(s)
- Dheeraj Reddy Gopireddy
- Department of Radiology, UF College of Medicine-Jacksonville, Jacksonville, Florida, United States
| | - Joanna W. Kee-Sampson
- Department of Radiology, UF College of Medicine-Jacksonville, Jacksonville, Florida, United States
| | - Sai Swarupa Reddy Vulasala
- Department of Internal Medicine, East Carolina University Health Medical Center, Greenville, North Carolina, United States.,Corresponding author: Sai Swarupa Reddy Vulasala, Department of Internal Medicine, East Carolina University Health Medical Center, Greenville, United States.
| | - Rachel Stein
- Department of Radiology, UF College of Medicine-Jacksonville, Jacksonville, Florida, United States
| | - Sindhu Kumar
- Department of Radiology, UF College of Medicine-Jacksonville, Jacksonville, Florida, United States
| | - Mayur Virarkar
- Department of Radiology, UF College of Medicine-Jacksonville, Jacksonville, Florida, United States
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Odedra D, Mellnick VM, Patlas MN. Imaging of Trauma in Pregnancy. Radiol Clin North Am 2023; 61:129-139. [DOI: 10.1016/j.rcl.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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The Use of Enteric Contrast in the Emergency Setting. Radiol Clin North Am 2023; 61:37-51. [PMID: 36336390 DOI: 10.1016/j.rcl.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Stephens J, Yu HS, Uyeda JW. Hepatobiliary Trauma Imaging Update. Radiol Clin North Am 2022; 60:745-754. [DOI: 10.1016/j.rcl.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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