Featured Article: International Masters Programmes in Trauma Sciences - Prospectus

Queen Mary University of London, TRAUMA.ORG and the Royal College of Surgeons of England are pleased to announce the start of two innovative new Masters programmes - A Masters in Trauma Sciences and a Masters in Trauma Sciences (Military & Austere).

Featured Case Study: Bilateral lower extremity gunshot wound with arterial and venous injury

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.

Post traumatic intraorbital arteriovenous fistula

payman Moharamzadeh, Tabriz University of Medical Sciences-Imam Reza Ho, August 04, 2011

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.

Bilateral lower extremity gunshot wound with arterial and venous injury

Gunshot injury to both lower limbs requiring vascular damage control

sam zeraatian nejad davani, December 26, 2010

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.

Traumatic diaphragmatic Injury (Right side)

b banga, December 22, 2010

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

A Stab Wound to the Right Auriculoventricular Junction

sam zeraatian nejad davani, October 18, 2010

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.

Fracture-dislocation of the thoracolumbar spine with multiple injuries

Cedillo J., Bolaños R.

Jesús Cedillo, Mexico, September 24, 2010

A 45 year old patient fell 3.5metres and sustained a fracture-dislocation of the thoracolumbar spine together with head, chest and abdominal injuries

Bladder Rupture Following Assault

Tiffany Frederickson, MD, 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

Tiffany Frederickson, MD, 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

sam zeraatian nejad davani, 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

Anas Abdullah, 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

Denis Allard, GF Jooste hospital Manenberg, 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?

Denis Allard, GF Jooste hospital Manenberg, 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

Ben Hickey, 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

Edoardo Ghirardi, 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.

Karim Brohi, London, UK, July 27, 2007

Gunshot to Carotid Artery

Gunshot carotid artery: angiogram & vein graft repair

Herb Phelan, Parkland Memorial Hospital, Dallas, TX, USA, 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.

Jonathan Farmery, 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.

Karim Brohi, London, UK, 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.

Angiographic Coiling for Pelvic Haemorrhage

Classic Case

, November 28, 2006

Classic Case: Tension Haemothorax

A classic description of the tension haemothorax

Karim Brohi, London, UK, July 01, 2006

A classic description of tension haemothorax.

Classic Case: Tension Gastrothorax

Karim Brohi, London, UK, 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.