Rahimeh Eskandarian; Abolfazl Abdollahpour; Shahrzad Aghaamoo; Narges Amini; Hoda Zangian; Kamran Ghods
Volume 10, Issue 3 , July 2022, , Pages 138-140
Abstract
Nowadays, the use of central venous catheter insertion (CVC), has abundantly increased. It is a common technique in critically ill patients who are admitted to intensive care and emergency departments in order to hemodynamic monitoring and fluid and medication administration. In this report, ...
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Nowadays, the use of central venous catheter insertion (CVC), has abundantly increased. It is a common technique in critically ill patients who are admitted to intensive care and emergency departments in order to hemodynamic monitoring and fluid and medication administration. In this report, we express a 28-year-old man who has multiple trauma with decreased level of consciousness during a car accident three months ago and needs intensive care and monitoring by central venous catheter placing. A missed guide wire remaining inside the venous system after peripherally inserted in femoral vein that was incidentally diagnosed by taking a chest X-ray after three months. Although, guide wires are often retrieved by snaring catheter under fluoroscopic guidance and an interventional cardiologist, we have successfully extracted the lost wire through vascular surgery. Eventually, this report is supposed to increase awareness of this rare and preventable complication and to provide a solution to prevent this complication. Finally, the purpose of this report is to emphasize that surgical extracting is the best intervention to remove the missed guide wire (after 3 months) and this optioncould be developed, introduced and standardized in appropriate and controlled conditions.
Nawal Kishore Jha; Sanjay Kumar Yadav; Rajshekhar Sharma; Dipendra Kumar Sinha; Sandip Kumar; Marshal Daud Kerketta; Mini Sinha; Abhinav Anand; Anjana Gandhi; Satish Kumar Ranjan; Jitin Yadav
Volume 2, Issue 4 , October 2014, , Pages 156-160
Abstract
Objective: To determine the presentation, anatomical distribution, diagnostic method, management and outcome of hollow viscus injury (HVI) from blunt abdominal trauma.Methods: This was a retrospective cross-sectional study including patients with blunt abdominal trauma leading to HVI admitted at Rajendra ...
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Objective: To determine the presentation, anatomical distribution, diagnostic method, management and outcome of hollow viscus injury (HVI) from blunt abdominal trauma.Methods: This was a retrospective cross-sectional study including patients with blunt abdominal trauma leading to HVI admitted at Rajendra Institute of Medical Sciences, Ranchi, over a period of 4.5 years (January 2009 to July 2014). Data were retrieved from patients’medical records. Total 173 patients with HVI due to blunt abdominal trauma, who underwent laparotomy at our institute, were reviewed. Data regarding clinical presentation, anatomical distribution, management and outcome were recorded and analysed.Results: Out of 173 patients 87.1% were men and 12.9% were women. Mean age of patients was 29 ± 14.02 years. The most common site of injury was ileum (46.2%) followed by jejunum (44.5%). There were 5 gastric perforations (2.9%), 2 (1.15%) duodenal, 2 (1.15%) colonic, 2 (1.15%) sigmoidal and 2 (1.15%) rectal injuries. One caecal injury was also recorded. Road traffic accident was the most common mechanism of injury (57.2%) followed by fall from height (36.4%) and assault (6.4%). Free gas under diaphragm on erect abdomen radiography was seen in 85.5% of cases while preoperative CT Abdomen was done in 11.6% of cases. Treatment consisted of simple closure of the perforation (66.5%), resection and anastomosis (11.0%) and stoma (22.5%). Major complication was anastamotic leak which was recorded in 6.4% cases and 15.6% patients developed burst abdomen. Average hospital stay was 13 ± 6 days. Overall mortality rate was 12.7%. Conclusion: Although early recognition of intestinal injuries from blunt abdominal trauma may be difficult in all cases, it is very important due to its tremendous life threatening potential. Age of the patient, anatomical site and time of presentation are probably main prognostic factors.