December 05, 2012
Post-trauamtic middle cerebral artery thrombosis
A case of a skydiver who lost control and landed in shallow water. He presented with a right knee injury and a delayed presentation of middle cerebral artery thrombosis 3 hours following the event.
November 28, 2012
Anal Necrosis Following Pelvic Crush Injury
Arterial haemorrhage within the pelvic circulation can be controlled by nonselective embolization. However, complications are associated with distal ischemia from disruption of the aortoiliac circulation. Reported complications of pelvic crush injury include impotence, lower extremity nerve deficits, left colon ischemia, spinal cord injury, and necrosis of the rectum and gluteal musculature. We report a case of anal canal necrosis after a pelvic crush injury attributed to hypotension, compression by pelvic hematoma, and arterial disruption after selective unilateral transcatheter arterial embolization (TAE).
August 13, 2012
A patient was transferred to the Emergency Department of our hospital, having sustained two major stab injuries to the upper abdomen.
Despite the challenges of delayed revision of acetabular fractures, severe haemorrhage leading to haemodynamic instability is not often encountered. Immediate intraoperative detection and cessation of the bleeding source is vital. We present a case highlighting an iliac nutrient foramen haemorrhage which almost resulted in a lethal haemorrhage during an open reduction of a delayed ace tabular fracture via the ilioinguinal approach.
August 04, 2011
Post traumatic intraorbital arteriovenous fistula
A patient with a history of previous closed head injury presented with chemosis, proptosis and conjunctival injection of the right eye. CT showed a dilated superior ophthalmic vein suggesting the presence of a carotid–cavernous sinus fistula.
20 years old man after civilian gunshot wound, arrived in our emergency department with profound shock and ongoing bleeding from gunshot wounds to both thighs.
December 22, 2010
Traumatic diaphragmatic Injury (Right side)
A middle aged female presented with multiple # ribs and right side haemothorax after a road accident. A chest tube was put in to drain the hemothorax. She was comfortable, no respiratory distress and maintaining the oxygen saturation without oxygen supplementation. There is decrease air entry at base and check X-ray revealed markedly elevated diaphragm on Rt. Side.
C.T.Chest-suspicion of traumatic diaphragmatic hernia with herniation of liver in thorax. I planned lateral thoracotomy through 7th I.C.space. Before opening I put Laparoscope through chest tube site and confirmed the diagnosis. Liver and a part of colon were in thorax. After opening both structures could be reduced easily. Rent in diaphragm repaired with 1/0 Prolene suture. Post operative – uneventful recovery
October 18, 2010
A Stab Wound to the Right Auriculoventricular Junction
A patient came to our hospital trauma center with profound shock following a stab attack. The stab entry point was the right anterior chest wall. The injury was repaired and the patient discharged following a good recovery.
September 24, 2010
Fracture-dislocation of the thoracolumbar spine with multiple injuries
A 45 year old patient fell 3.5metres and sustained a fracture-dislocation of the thoracolumbar spine together with head, chest and abdominal injuries
August 26, 2010
Bladder Rupture Following Assault
An assaulted patient is found to have rib fractures and an intraperitoneal bladder rupture that was repaired during an exploratory laparotomy.
August 21, 2010
Aortic Dissection in Blunt Trauma
A patient involved in a car accident causing his vehicle to roll, sustained an aortic dissection just distal to the renal arteries requiring open aortic grafting to repair it.
July 31, 2010
Biventricular shotgun injury of the heart
20 years old man came with profound shock and bilateral massive hemothorax and jugular vein distension as result of cardiac tamponade. He underwent successful cardiac repair and had an uneventful post operative course.
Coeliac arterial aneurysms are rare, but with significant risk of rupture, multiple methods of treatment have been successful and early recognition and intervention is crucial.
August 04, 2009
Venous laceration to lower limb without fasciotomy
Trauma surgeons deal rarely with isolated penetrating venous injuries to the lower limbs due to the proximity of the vein-arterial complex. The limb remains vascularized but intensely swollen and a fasciotomy must be considered. Inserting a 'drip line' into both severed ends permits immediate venous return and improves the venous hypertension to the point where a fasciotomy can be avoided. This 'damage control' act does allow one to come back a day later and to reestablish continuity with any interposition graft available. The contralateral long saphenous is first choice, a synthetic graft second, a ligature and fasciotomy third choice.
January 10, 2009
Penetrating Cardiac Injuries
82% survival in 35 consecutive stab heart patients was achieved in a South African metropolitan community hospital during the year 2008. Excellent and expediant prehospital management, skilled emergency room personnel and available surgical skill is necessary to achieve these results. The survival rate depends on the number of patients analyzed. The last 160 patients have a 70% survival rate, the last 35 patients have an 82% survival rate. Every surgical team can achieve good results under appropriate leadership.
October 05, 2008
C-spine fractures following falls in older patients
This case highlights the importance of the history and high index of suspicion of c-spine fracture older patients following falls.
March 15, 2008
Impalement on the top of fence
Thoracic trauma caused by a dart on the top of a fence.
July 27, 2007
Thoracic gunshot and retroaortic bullet
The patient sustained a gunshot wound to the lower right thorax. He was admitted to the emergency department and remained haemodynamically normal throughout his assessment. There was a right pneumothorax…
July 10, 2007
Gunshot to Carotid Artery
A gunshot wound to the left neck, disrupting the internal and external carotid arteries. Operative repair with reversed vein graft.
We write describing our experience using the First Access for Shock and Trauma (FAST1) intra-osseous (I/O) cannula to perform a rapid sequence induction (RSI) at the roadside. The casualty was the victim of an RTC with difficult IV access and in urgent need of anaesthesia due to airway compromise and severe head injury. The I/O cannula was sited swiftly and without difficulty despite the patient being in the right decubitus position for postural airway drainage. Onset of anaesthesia/muscle relaxation showed no discernable delay compared with the intravenous route. Fluid flow and cannula security were also adequate.
January 08, 2007
Superficial Femoral Artery Impalement. Arterial Shunt
A combined femur fracture and superficial femoral artery impalement injury managed with temporary shunting to restore flow before fracture fixation and definitive repair.
November 28, 2006
Angiographic Coiling for Pelvic Haemorrhage
A 47 year old man is brought to the trauma centre having had a wall collapse…
July 01, 2006
Classic Case: Tension Haemothorax
A classic description of tension haemothorax.
July 01, 2006
Classic Case: Tension Gastrothorax
A rare case of tension gastrothorax following blunt trauma and diaphragmatic rupture.
October 16, 2005
Infrahepatic Inferior Vena Cava injury
Gunshot wound to the abdomen, with injury to the lateral wall of the infrahepatic inferior vena cava. The IVC was accessed through a right medial visceral rotation and a lateral repair performed.