Featured Article: Standards for the management of open fractures of the lower limb
New comprehensive, evidence based guidelines on the management of open fractures should lead to reorganisation of service delivery and a more comprehensive approach to these potentially catastrophic injuries.
Featured Case Study: 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.
Featured Images
-
Total inflow occlusion manoeuvre of the heart
Occlusion of the venous return to right cardiac chambers by clamping the superior and inferior vena cava
Lt Col Luis Manuel Garcia-Nunez MD Military Central Hospital, Mexico City.
-
Postraumatic hepatothorax
CT scan of a hepatothorax
Major Olliver Nunez-Cantu MD Central Military Hospital, Mexico City.
-
Pulmonary contusion injury in blunt trauma
A pulmonary contusion
Dr. Gabriel Mejia Consuelos, SF, ACS, COT Hospital General Balbuena, Mexico City
-
Grade III Blunt Pancreatic Injury 02
Intraoperative Findings
Juan C Duchesne MD, FACS, FCCP Spirit Of Charity Hospital, NOLA
-
Grade III Blunt Pancreatic Injury 01 - CT Scan
CT abdomen with Grade III Blunt Pancreatic Injury
Juan C Duchesne MD, FACS, FCCP Spirit Of Charity Hospital, NOLA
-
Right Atrial Injury
Injury to the right atrium
Juan C Duchesne MD, FACS, FCCP Spirit of Charity Hospital, New Orleans
Recent Images
-
Diaphragmatic rupture following blunt abdominal trauma 02
CT scan of right hepatothorax
Nutcha Yodrabum MD, Maharajnakhonrachasima Hospital Thailand
-
Diaphragmatic rupture following blunt abdominal trauma 01
CT scan of right hepatothorax
Nutcha Yodrabum MD, Maharajnakhonrachasima Hospital Thailand
-
Subdural haematoma from knife wound 06
Juan Carlos Mora Ospina M.D. Emergency Department, Hospital Occidente de Kennedy, Bogota, Colombia
-
Subdural haematoma from knife wound 05
CT brain - bone window
Juan Carlos Mora Ospina M.D. Emergency Department, Hospital Occidente de Kennedy, Bogota, Colombia
-
Subdural haematoma from knife wound 04
Coronal CT of subdural haematoma
Juan Carlos Mora Ospina M.D. Emergency Department, Hospital Occidente de Kennedy, Bogota, Colombia
-
Subdural haematoma from knife wound 03
Lateral radiograph of skull with clasp-knife in-situ
Juan Carlos Mora Ospina M.D. Emergency Department, Hospital Occidente de Kennedy, Bogota, Colombia
Article List
Case Presentations
Bladder Rupture Following Assault
, August 26, 2010
An assaulted patient is found to have rib fractures and an intraperitoneal bladder rupture that was repaired during an exploratory laparotomy.
Aortic Dissection in Blunt Trauma
, August 21, 2010
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.
Cardiac laceration
, August 13, 2010
A patient was transferred to the Emergency Department of our hospital, having sustained two major stab injuries to the upper abdomen.
Biventricular shotgun injury of the heart
with involvment of proximal RCA and LAD
, July 31, 2010
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.
A Coeliac artery aneurysm - An uncommon risk of blunt abdominal trauma
Coeliac artery aneurysms are rarely seen clinically. We report an unusual case of a large coeliac artery aneurysm in a boxer who presented with vague abdominal pain and a pulsatile epigastric
, May 17, 2010
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.
Venous laceration to lower limb without fasciotomy
Shunting superficial femoral vein to avoid fasciotomy
, August 04, 2009
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.
Penetrating Cardiac Injuries
How to get the best possible outcome?
, January 10, 2009
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.
C-spine fractures following falls in older patients
The importance of history taking and clinical suspicion
, October 05, 2008
This case highlights the importance of the history and high index of suspicion of c-spine fracture older patients following falls.
Impalement on the top of fence
, March 15, 2008
Thoracic trauma caused by a dart on the top of a fence.
Thoracic gunshot and retroaortic bullet
An example of why bullets should not be removed.
, July 27, 2007
Gunshot to Carotid Artery
Gunshot carotid artery: angiogram & vein graft repair
, July 10, 2007
A gunshot wound to the left neck, disrupting the internal and external carotid arteries. Operative repair with reversed vein graft.
Atypical use of the FAST1 manubrial intraosseous cannula.
Submitted by Farmery S, FRCA, Dip IMC and Balderston G, SR Para.
, June 15, 2007
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.
Superficial Femoral Artery Impalement. Arterial Shunt
Demonstrating the utility of an arterial shunt prior to definitive repair.
, January 08, 2007
A combined femur fracture and superficial femoral artery impalement injury managed with temporary shunting to restore flow before fracture fixation and definitive repair.
Classic Case: Tension Haemothorax
A classic description of the tension haemothorax
, July 01, 2006
A classic description of tension haemothorax.
Classic Case: Tension Gastrothorax
, July 01, 2006
A rare case of tension gastrothorax following blunt trauma and diaphragmatic rupture.
Infrahepatic Inferior Vena Cava injury
Lateral repair
, October 16, 2005
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.
