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 ...
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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 ...
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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.
