Deepak Kumar; Praveen Sodavarapu
Volume 8, Issue 2 , April 2020, , Pages 125-128
Abstract
Injury to the femoral artery usually occurs either in open penetrating injuries or in association with fractures, but is unlikely with closed blunt trauma without fracture. We reported a 24-year-old female with a right-sided closed complete rupture of the superficial femoral artery without any bone injury ...
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Injury to the femoral artery usually occurs either in open penetrating injuries or in association with fractures, but is unlikely with closed blunt trauma without fracture. We reported a 24-year-old female with a right-sided closed complete rupture of the superficial femoral artery without any bone injury and contralateral femoral shaft fracture following riding a bike and hitting by a tractor over both lower limbs. The right thigh and knee were swollen and tender with absent distal pulses without any knee instability. The left lower limb was shorter with crepitus and abnormal movement in the left thigh and intact distal pulses. Radiographs showed left femoral shaft fracture and no bony injury on the right lower limb. Angiogram showed non-opacification of the right distal superficial femoral artery. Fogartisation of distal and proximal ends were done and femoral artery was reconstructed using reversed saphenous vein interposition graft. So the clinical necessity of looking routinely for any arterial injury, even in cases of blunt trauma without bony injury is of great importance.
Hassan Al-Thani; Gaby Jabbour; Ayman El-Menyar; Husham Abdelrahman; Ruben Peralta; Ahmad Zarour
Volume 6, Issue 1 , January 2018, , Pages 16-25
Abstract
Objective: To investigate the presentation, management and outcomes of left and right-sided traumatic diaphragmatic injury (TDI) in a single level I trauma center.Methods: This cross-sectional study was conducted during a 7-year period from 2008 to 2015 in a level I trauma center in Qatar. We included ...
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Objective: To investigate the presentation, management and outcomes of left and right-sided traumatic diaphragmatic injury (TDI) in a single level I trauma center.Methods: This cross-sectional study was conducted during a 7-year period from 2008 to 2015 in a level I trauma center in Qatar. We included all the patients who presented with TDIs during the study period. Data included demographics, mechanism of injury, associated injuries, initial vitals, emergency department disposition, length of ICU and hospital stay, ventilator days, management, and outcomes. The variables were analyzed and compared for patients with left (LTDI) and right (RTDI).Results: A total of 52 TDI cases (79% LTDI and 21% RTDI) were identified with a mean age of 31±11. LTDI patients were more likely to have higher Injury severity scores (p=0.50) and greater AAST organ injury scoring (p=0.661 for all) than RTDI patients. Surgical repair was performed for 85% LTDI vs. 73% RTDI (p=0.342). Recurrent DIs was reported only in LTDI (5.1% vs. 0.0%; p=0.911). Twelve patients died (9 LTDI and 3 RTDI), of them 5 had associated head injury.Conclusion: This single-institution study confirms that LTDI are more commonly diagnosed than RTDI. Exploratory laparotomy is the most frequent procedure considered for the management of diaphragmatic injuries in the emergency settings. To improve outcomes in patients presenting with TDI, large prospective multicenter studies are needed to standardize the TDI management protocols including the diagnostic workup, timing of surgical intervention, and the most appropriate approach of treatment.
