Abstract Pneumomediastinum (PM) with pneumopericardium and subcutaneous emphysema is an uncommon finding following blunt trauma. Traumatic Pneumomediastinum occurs in 10% of cases of blunt trauma to chest. Most of the cases are due to alveolar rupture and leak of air from the pneumothorax, rest are due to Macklin effect. CT scan is the primary imaging modality to detect pneumomediasinum at an earlier stage that can be life threatening. We present here a case of 45 years old male with alleged history of road traffic accident with fracture first rib who developed pneumomediastinum, pneumopericardium and subcutaneous emphysema due to Macklin effect without associated pneumothorax which resolved spontaneously on conservative management.
This was reinforced with pericranial onlay patch also.Intraoperative valsalva maneuver showed no csf leak.Wound was closed in layers with prophylactic continous lumbar drainage.Post operative CT scan showed complete resolution of pseudomeningocele(Fig9) Fig9: Post operative CT scan after repair of dural leak and excision of pseudomeningocele sac. Lumbar drain was removed on 3rd day.patient was discharged of day 10 with no evidence of
This can be due to Small study group comprising 65 patients, Irregular presence of onsite cytopathologist for supervision (11, 12), 4 patients were lost on follow up. Therefore the presence of cytopathologist produces good diagnostic yield. Incidence of complication due to the procedure of CT guided transthoracic fine-needle aspiration cytology of lung lesions. The literature states the most common complication to be pneumothorax. In our study the incidence of pneumothorax is16% (11 cases) none of which required placement of chest drainage tubes.
A pneumothorax can be caused by physical trauma to the chest wall or as a complication of a healthcare intervention which is referred to as traumatic pneumothorax. In a minority of cases the amount of air in the chest increases markedly when a one-way valve is formed by an area of damaged tissue, leading to a tension pneumothorax which leads to steadily worsening oxygen shortage and low blood pressure. Unless reversed by effective treatment, it can result in death. Diagnosis of a pneumothorax by physical examination alone can be difficult. Integrated diagnostic modalities can be used for the better detection such as chest X-ray,
In this a reinforced scalpel and a mallet to go through gingival and cortical bone was used without raising flap. This technique although innovative had two drawbacks: firstly the inability to graft soft or hard tissues during procedure to correct inadequacies and reinforce the periodontium and secondly repeated malleting caused dizziness after surgery. In 2009 Dibart et al proposed a new and minimally invasive procedure that was called ‘piezocision’. This approach combines microincisions to the buccal gingival that allows for the use of piezoelectric knife to decorticate the alveolar bone to initiate the RAP. It has the advantage of allowing hard tissue or soft tissue grafting via selective tunnelling to correct gingival recession or bone deficiencies in patients and also in spite of being more conservative approach towards surgery it induces more extensive and diffuse demineralization followed by increased remineralization effect on the bone.
An intercostal drain was inserted for hemothorax and exploratory laparotomy with splenectomy was performed as an emergency. The patient was transferred to intensive care unit in view of haemodynamic instability and blood loss. Mechanical ventilation was initiated with synchronised intermittent mode of mandatory ventilation (SIMV).Sedation and analgesia were provided with infusion of morphine (3 mg/hr) and midazolam (2mg/hr) as per the institutional protocol. Subsequently SAM block was administered in view of fractured ribs on left side using a using high-frequency (5–10 MHz) ultrasound probe and 20 ml of 0.5 % Ropivacaine was deposited between the neurofascial plane between Latissimus dorsi (LDm) and serratus anterior muscle (SAM) after negative aspiration at the level of fifth rib using a 25 G spinal needle. Subsequent to block, the hemodynamics of the patient improved and the need for sedation and analgesia reduced and was later on stopped as patient was completely pain free.
Case Report: Posterior Hip Dislocation with Ipsilateral Femoral Head and Shaft Fracture - Using a Temporary External Fixator as a Method for Closed Reduction Abduljabbar Alhammouda,1, Mason AlNouria, Abdulmoeen Bacoa a Hamad Medical Corporation, Department of Orthopedic Surgery, P.O. Box 3050, Doha, Qatar Corresponding author. Email: firstname.lastname@example.org All of the authors stated above have read and approved this manuscript The authors have no conflicts of interest to declare Type of Manuscript: Case Report Abstract INTRODUCTION: Complex fractures are increasing because of various traumatic mechanisms. They drift from standard classifications, and their treatment is controversial. Of such cases are hip dislocations with associated
Brief Description of Pneumoconiosis: Pneumoconiosis is the generic term given to any lung disease caused by the inhalation of dust which is then retained deep in the lungs causing damage. Because you are likely to encounter these dusts only in the workplace, Pneumoconiosis is generally known to be an occupational lung disease, and includes asbestosis, silicosis and coal workers' pneumoconiosis (CWP), which is also known as "Black Lung Disease", because the charcoal dust in the lungs can cause them to turn black in color. Mode of Transmission: Pneumoconiosis occurs when airborne dust particles, particularly mineral dusts, are inhaled at work. The particles are retained in the lungs where they can cause inflammation or fibrosis (scarring). Typically, there is a long delay between the time of exposure to dust to the onset of the disease, so symptoms may not appear in patients until