Hamed Ghoddusi Johari; Seyed Arman Moein
Articles in Press, Accepted Manuscript, Available Online from 20 November 2021
Abstract
Blunt traumatic aortic injury is a deadly phenomenon in traumatic injuries. Damage control is essential in the management of traumatic patients. We reported a 20-years-old man brought to the trauma center from a car turnover crash scene. Blunt traumatic aortic injury grade III was revealed ...
Read More
Blunt traumatic aortic injury is a deadly phenomenon in traumatic injuries. Damage control is essential in the management of traumatic patients. We reported a 20-years-old man brought to the trauma center from a car turnover crash scene. Blunt traumatic aortic injury grade III was revealed by contrast-enhanced computed tomography requiring urgent intervention. After an uneventful open repair of the aorta with Dacron graft, diffuse blood oozing occurred from the mediastinum and left pleural cavity. We packed the thoracic bleeding sites and removed the packings after four days. The patient developed no signs of cardiopulmonary compromise until the removal of the packings. Later, the patient was discharged with no complications. Through the followups, he had no complaint regarding the surgery. The patient has a normal chest x-ray one year later. Thoracic gauze packing is limitedly practiced due to concerns for cardiopulmonary compromises. To the best of our knowledge, this is the first time that this technique has been performed in the open repair of blunt traumaticthoracic aortic injury as damage control.
Hamed Ghoddusi Johari; Seyed Arman Moein; Ahmad Hosseinzadeh; Javad Kojuri; Amirhossein Roshanshad; Reza Shahriarirad
Volume 10, Issue 3 , July 2022, , Pages 103-109
Abstract
Objective: To evaluate the efficacy of chest x-ray (CXR) in blunt traumatic aortic injury (BTAI) as a primaryimaging tool in trauma patients.Methods: We retrospectively reviewed our hospital records for blunt thoracic aortic injury patients who had atherapeutic intervention from January 2015 to February ...
Read More
Objective: To evaluate the efficacy of chest x-ray (CXR) in blunt traumatic aortic injury (BTAI) as a primaryimaging tool in trauma patients.Methods: We retrospectively reviewed our hospital records for blunt thoracic aortic injury patients who had atherapeutic intervention from January 2015 to February 2021. Patients’ characteristics, initial chest x-rays, andcomputed tomography (CT) scan were extracted and re-evaluated.Results: Eighteen patients matched the criteria of our research. The mean age and the injury severity score(ISS) was 29.8±11.2 and 38.4±14.4, respectively. Seven patients (38.9%) underwent thoracic endovascularaortic repair (TEVAR), and 11 (61.1%) had open surgery. The TEVAR group had significantly lower meanintensive care unit stay days (6.6±3.9 vs. 10.8±6.9 in open aortic repair (OAR), p<0.05). The percentile ofpatients requiring blood transfusion was significantly lower in the TEVAR group (57% vs. 100% in OAR,p<0.05). Mediastinal widening (66.7%) was the most common finding during the evaluation of initial chestx-rays. Interestingly, 22.2% of the initial x-rays were not remarkable for BTAI.Conclusion: TEVAR is an advantageous choice in the management of BTAI. However, open aortic repair is theoptimal decision in certain situations. It is suggested that the Interventional management of the BTAI must beperformed by experienced vascular surgeons in a medical center capable of both OAR and TEVAR.
Parviz Mardani; Reza Shahriarirad; Amirhossein Erfani; Keivan Ranjbar; Bizhan Ziaian; Armin Amirian; Hamed Ghoddusi Johari
Volume 9, Issue 1 , January 2021, , Pages 42-45
Abstract
Tube thoracostomy has been known to be a common and invasive, however not innocuous, procedure which is often life-saving. Though, numerous complications have been reported during executing this procedure. In this report, we describe a 27-year-old woman, case of multiple trauma due to car collision ...
Read More
Tube thoracostomy has been known to be a common and invasive, however not innocuous, procedure which is often life-saving. Though, numerous complications have been reported during executing this procedure. In this report, we describe a 27-year-old woman, case of multiple trauma due to car collision that was transferred to our service due to severe right side chest tube air leak and subcutaneous emphysema in which after proper evaluation, it was revealed that the chest tube crossed through the right pleural cavity and penetrated the bronchus intermedius. A literature search failed to identify a similar case. The misplacement was confirmed by fiber optic bronchoscopy and after surgical and intensive care management of the patient, she was dischargedwith an uneventful post-op course. This case noticeably determines that bearing in mind the extreme risks and the careful checks of the tube location are required, particularly in trauma patients, even in the absence of anatomical abnormalities.
Hossein Hodjati; Hamed Ghoddusi Johari; Bizhan Khademi; Abdolkarim Rahmanian; Abtin Vahidi; Maryam Dehghankhalili
Volume 7, Issue 4 , October 2019, , Pages 420-423
Abstract
The aneurysms of the extracranial segment of the internal carotid artery are not common and are associated with severe neurologic deficits. They could be misdiagnosed with several lesion of the cervical region. We herein report a case of internal carotid artery aneurysm misdiagnosed as paraganglioma. ...
Read More
The aneurysms of the extracranial segment of the internal carotid artery are not common and are associated with severe neurologic deficits. They could be misdiagnosed with several lesion of the cervical region. We herein report a case of internal carotid artery aneurysm misdiagnosed as paraganglioma. A 23-year-old man presented with progressive growing mass in right enlarging mass in the upper part of the neck below the angle of the mandible. The patient underwent surgery by the ear, nose, throat (ENT) surgeon through submandibular approach with impression of paraganglioma but severe pulsatile bleeding was encountered intraoperatively. Two vascular clamps were applied and the patient was transferred to the vascular ward. Computerized tomography (CT) angiogram revealed a huge aneurysm of the internal carotid artery in the extracranial segment with injured wall. After 2 days of medical therapy the patient was transferred to the operating room and the aneurysm was repaired using Dacrons. The patient had an uneventful hospital course and was asymptomatic after 1 year of follow-up. Precise preoperative assessment and evaluation with different modalities should be performed to avoid fatal complications. Surgery is a safe and effective method in experienced hands for repair of such aneurysms.
Shahram Paydar; Zahra Ghahramani; Hamed Ghoddusi Johari; Samad Khezri; Bizhan Ziaeian; Mohammad Ali Ghayyoumi; Mohammad Javad Fallahi; Mohammad Hadi Niakan; Golnar Sabetian; Hamid Reza Abbasi; Shahram Bolandparvaz
Volume 3, Issue 2 , April 2015, , Pages 37-40
Abstract
Chest tube (CT) or tube thoracostomy placement is often indicated following traumatic injuries. Premature movement of the chest tube leads to increased hospital complications and costs for patients. Placement of a chest tube is indicated in drainage of blood, bile, pus, drain air, and other fluids. Although ...
Read More
Chest tube (CT) or tube thoracostomy placement is often indicated following traumatic injuries. Premature movement of the chest tube leads to increased hospital complications and costs for patients. Placement of a chest tube is indicated in drainage of blood, bile, pus, drain air, and other fluids. Although there is a general agreement for the placement of a chest tube, there is little consensus on the subsequent management. Chest tube removal in trauma patients increases morbidity and hospital expense if not done at the right time. A review of relevant literature showed that the best answers to some questions about time and decision-making have been long sought. Issues discussed in this manuscript include chest tube removal conditions, the need for chest radiography before and after chest tuberemoval, the need to clamp the chest tube prior to removal, and drainage rate and acceptability prior to removal.
