Right Atrial Rupture Due to Non-thoracic Deceleration Injury
Sujith Neralakere Suresha,
Paritosh Ballal,
Navin Lal
Issue:
Volume 8, Issue 4, July 2022
Pages:
39-41
Received:
23 March 2022
Accepted:
19 April 2022
Published:
28 July 2022
DOI:
10.11648/j.ijcts.20220804.11
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Abstract: Right atrial rupture is predominantly caused by direct thoracic trauma. Non thoracic injuries leading to cardiac rupture is rare. Cardiac injury is responsible for a majority of the deaths following trauma. Exact figures are unavailable in our country. With the increasing number of high-speed vehicular accidents, many patients sustain cardiac rupture, but are not transported to the hospital in time and they succumb to the injuries. There are reports of patients having survived following surgery for cardiac rupture. Most of these are secondary to direct trauma. We describe our experience of treating two cases of cardiac rupture due to non-thoracic trauma and the anatomical and pathophysiological rationale for the occurrence of this rare, but eminently treatable injury. With modern technology, it is easy to diagnose these injuries by echocardiography, if the treating team is aware of the condition. Most patients who survive the initial hours have injury localized to the right atrium. There may be associated injuries to the other cardiac chambers, and all require rapid diagnosis and treatment. The key to diagnosis and treatment is in high index of suspicion of this injury within the golden hour; recognition of hemopericardium on echocardiogram and emergency explorative surgery and repair of the atrial tear.
Abstract: Right atrial rupture is predominantly caused by direct thoracic trauma. Non thoracic injuries leading to cardiac rupture is rare. Cardiac injury is responsible for a majority of the deaths following trauma. Exact figures are unavailable in our country. With the increasing number of high-speed vehicular accidents, many patients sustain cardiac ruptu...
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The Changing Pattern of Chest Trauma in Sokoto: A 10-Year Institutional Review
Ukwuani Solomon Ifeanyi,
Salisu Ismail,
Ray Bayo,
Maishanu Moyijo,
Isah Abdullahi,
Abdullahi Abdulkarim Aitek,
Abdulrahman Aliyu,
Galadima Ibrahim,
Abubakar Umar
Issue:
Volume 8, Issue 4, July 2022
Pages:
42-48
Received:
28 May 2022
Accepted:
28 June 2022
Published:
28 July 2022
DOI:
10.11648/j.ijcts.20220804.12
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Abstract: Background: Chest trauma is a public health problem because it is a major contributor to the burden of trauma-related morbidity and mortality. Low and middle-income countries (LMICs) account for 90% of these poor outcomes, which dominantly affect the younger age groups and men. Blunt chest trauma and road traffic accidents are the main type and mechanism of injury respectively. We aimed to describe the changing epidemiology of chest trauma in terms of the demographic characteristics of patients, mechanism and pattern of injuries, treatment and outcomes over a 10-year period. Method: This is a retrospective descriptive study of all patients who required hospitalization following trauma and were managed for chest trauma by the cardiothoracic surgery Unit of the Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, between 1st January 2012 and 31st December 202. Results: A total of 287 patients were managed for chest trauma over this period. The mean age was 36.02 ± 15.64 years, with a male:female ratio of 8.6:1. There was a significant increase in the yearly number of cases in the later 3 years (2018 - 2021) compared to the first 7 years (p < 0.0001), and more males were affected within this period (p < 0.0001). Overall, blunt chest injury and road traffic accidents were the commonest mechanism and aetiology of injury respectively however penetrating chest injury from gunshot has superseded blunt chest injuries as the predominant mechanism and aetiology respectively in the last 3 years. Pleural space collections (haemopneumothorax, haemothorax and pneumothorax), rib fractures and pulmonary contusion were the commonest injury patterns and 24.04% had extrathoracic injuries which were significantly associated with mortality (p < 0.000). The majority of patients were managed conservatively or with tube thoracostomy. Only 12.5% required surgery and diaphragmatic injury was the commonest indication. The mortality rate was 9.1%. Conclusion: Chest trauma in Sokoto is predominantly a disease of young and middle-aged men. The rising incidence is mainly due to increasing cases of penetrating chest trauma from a gunshot in the last 3 years. This period also coincides with the increasing proliferation of small arms and light weapons in the region.
Abstract: Background: Chest trauma is a public health problem because it is a major contributor to the burden of trauma-related morbidity and mortality. Low and middle-income countries (LMICs) account for 90% of these poor outcomes, which dominantly affect the younger age groups and men. Blunt chest trauma and road traffic accidents are the main type and mec...
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Endobronchial Schwannoma: Literature Review in Account of a Case Report
Jose Ruben Lopez Franco,
Salvador Narvaez Fernandez,
Tania Perez Marmolejo,
Gibran Pliego Cervantes,
Ventura Molina,
Roland Kevin Cethorth Fonseca,
Edgard Efren Lozada Hernandez
Issue:
Volume 8, Issue 4, July 2022
Pages:
49-54
Received:
3 August 2022
Accepted:
19 August 2022
Published:
29 August 2022
DOI:
10.11648/j.ijcts.20220804.13
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Abstract: Background: Schwannomas are benign mesenchymal tumor originated in the Schwan cells of peripheral, spinal, or cranial nerve sheaths. They represent approximately 0.2-2% of benign tumors in the tracheobronchial tree. To date, only sporadic case reports exist in western literature. Case presentation: We present a 35-year-old female, whose initial complaints were dyspnea, persistent cough, and chest pain for two months. In a chest CT-scan, a solid tumor was identified in the juncture of the right main bronchus and the emergence of the ipsilateral superior bronchus. Said tumor had both an intra and extra-luminal component, and its dimensions where 2.9×2.6×2.7cm. Results: A right posterolateral thoracotomy was performed with selective intubation. The possibility of preserving the right upper lobe was identified transoperatively, with the right upper bronchus being sutured to the right main bronchus, without complications. The histopathologic report was of a benign bronchial Schwannoma, with the formation of Verocay bodies in the HE stain, and intense positivity for the S100 protein in the subepithelial lesion. Patient follow-up was performed with a new CT-scan and flexible bronchoscopy 3 months after surgery, with no evidence of recurrence. 23 cases of endobronchial Schwannoma reported in the available literature were subsequently analyzed, with emphasis on clinical presentation, treatment offered and follow-up. Conclusions: Endobronchial Schwannomas are an uncommon type of airway tumor, and are rarely thought of as an initial diagnosis. Total resection of the tumor is of upmost importance to avoid recurrence. Surgical resections should be considered in all patients with high probability of residual tumor through endoscopic resection, most notably those with a known or suspected extraluminal component. More case reports are needed to develop a better understanding of the best diagnostic, treatment, and follow-up options.
Abstract: Background: Schwannomas are benign mesenchymal tumor originated in the Schwan cells of peripheral, spinal, or cranial nerve sheaths. They represent approximately 0.2-2% of benign tumors in the tracheobronchial tree. To date, only sporadic case reports exist in western literature. Case presentation: We present a 35-year-old female, whose initial com...
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