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Case Reports
A method of bedside urethrography before catheterization in pelvic trauma in Korea: a case report
Hojun Lee, Sung Yub Jeong, Kun Hwang
J Trauma Inj. 2023;36(4):451-453.   Published online December 20, 2023
DOI: https://doi.org/10.20408/jti.2023.0047
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  • 23 Download
AbstractAbstract PDF
We introduce a convenient method of urethrography before catheterization for patients with pelvic trauma that can be used in a resuscitation area. A 10-mL syringe without a needle was used. X-ray contrast medium (Iohexol, 300 mg I/mL) was administered through the urethral orifice using a 10-mL syringe without needle and a simple pelvic anteroposterior film was taken (70 kilovolt [peak], 50 mAs). A 36-year-old soldier with a saddle injury from a gun barrel was taken to a trauma center. He had a pelvic fracture and complained of hematuria. Bedside urethrography above described was performed. The anterior urethra showed nonspecific findings, but dye leaked from the posterior urethra. Bedside Foley catheter insertion was attempted, but the catheter could not be advanced past the membranous urethra. Thereafter, suprapubic catheterization was performed. On the day of the injury, iliac artery embolization was carried out. The dislocated sacroiliac joint was also treated using open reduction and internal fixation. On hospital day 7, guidewire Foley insertion was performed. This bedside urethrography technique is simple and useful for pelvic fractures in which urethral injury is suspected.
Summary
Penetrating right ventricular injury following a single gunshot to the left flank in Iraq: a case report
Zryan Salar Majeed, Yad N. Othman, Razhan K. Ali
J Trauma Inj. 2023;36(3):253-257.   Published online April 19, 2023
DOI: https://doi.org/10.20408/jti.2022.0073
  • 1,816 View
  • 44 Download
AbstractAbstract PDF
A century ago, cardiac injuries usually resulted in death. However, despite all the advances in medicine, these injuries still have high mortality and morbidity rates. In the present case, we describe a patient with a bullet injury to the right ventricle who survived at our hospital despite the limitations of our center with regard to modalities and equipment. A 30-year-old man was brought to our emergency department with a bullet wound to his left flank. He was hemodynamically unstable. After only 8 minutes in the hospital and without further investigations he was rushed to the operating room. During laparotomy, a clot was visible in the left diaphragm, which dislodged and caused extensive bleeding. The decision was made to perform a sternotomy in the absence of a sternal saw. An oblique 8-cm injury to the right ventricle was discovered following rapid exploration. It was repaired without the need for cardiopulmonary bypass surgery. After a few days in the hospital, the patient was discharged home. In the event of a penetrating cardiac injury, rapid decision-making is crucial for survival. Whenever possible, the patient should be transferred to the operating room, as emergency department thoracotomies are associated with a high mortality rate.
Summary
Posttraumatic bilateral thigh Morel-Lavallée lesions without an underlying bone fracture in the United Kingdom: a case report
Sarah Razaq, James Geffner, Asma Khan, Harry Mee, Cynthia Udensi, Fahim Anwar
J Trauma Inj. 2023;36(3):269-275.   Published online January 11, 2023
DOI: https://doi.org/10.20408/jti.2022.0060
  • 3,322 View
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AbstractAbstract PDF
A Morel-Lavallée lesion results from a degloving injury between the muscle fascia and the subcutaneous layer. It is most commonly found in the trochanteric area but can occur at other sites. The treatment of the condition varies according to the medical circumstances, as well as the size and chronicity of the condition. A case of large (18×6 and 10×5 cm) bilateral posttraumatic Morel-Lavallée lesions with no underlying bone fracture is presented; the case occurred in a 49-year-old male patient 4 weeks posttrauma. Ultrasound scans showed bilateral large collections of anechoic fluid, which were aspirated under ultrasound guidance and further managed by compression bandages. There were no further complications. The objective of this case report is to present this unique and educational case, as well as to provide an overview of the pathophysiology, diagnosis, and management of Morel-Lavallée lesions. We conclude by discussing the importance of having a high index of suspicion to ensure early detection and prompt treatment of such lesions to avoid complications.
Summary
Special Article
Part 4. Clinical Practice Guideline for Surveillance and Imaging Studies of Trauma Patients in the Trauma Bay from the Korean Society of Traumatology
Sung Wook Chang, Kang Kook Choi, O Hyun Kim, Maru Kim, Gil Jae Lee
J Trauma Inj. 2020;33(4):207-218.   Published online December 31, 2020
DOI: https://doi.org/10.20408/jti.2020.0084
  • 4,099 View
  • 103 Download
AbstractAbstract PDF

The following recommendations are presented herein: All trauma patients admitted to the resuscitation room should be constantly (or periodically) monitored for parameters such as blood pressure, heart rate, respiratory rate, oxygen saturation, body temperature, electrocardiography, Glasgow Coma Scale, and pupil reflex (1C). Chest AP and pelvic AP should be performed as the standard initial trauma series for severe trauma patients (1B). In patients with severe hemodynamically unstable trauma, it is recommended to perform extended focused assessment with sonography for trauma (eFAST) as an initial examination (1B). In hemodynamically stable trauma patients, eFAST can be considered as the initial examination (2B). For the diagnosis of suspected head trauma patients, brain computed tomography (CT) should be performed as an initial examination (1B). Cervical spine CT should be performed as an initial imaging test for patients with suspected cervical spine injury (1C). It is not necessary to perform chest CT as an initial examination in all patients with suspected chest injury, but in cases of suspected vascular injury in patients with thoracic or high-energy damage due to the mechanism of injury, chest CT can be considered for patients in a hemodynamically stable condition (2B). CT of the abdomen is recommended for patients suspected of abdominal trauma with stable vital signs (1B). CT of the abdomen should be considered for suspected pelvic trauma patients with stable vital signs (2B). Whole-body CT can be considered in patients with suspicion of severe trauma with stable vital signs (2B). Magnetic resonance imaging can be considered in hemodynamically stable trauma patients with suspected spinal cord injuries (2B).

Summary

J Trauma Inj : Journal of Trauma and Injury
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