Critical Care
Balaji RajaRam; Sayan Nath; Supreet Kaur; Dinesh Bagaria; Rajeshwari Subramaniam; Vimi Rewari
Volume 9, Issue 1 , January 2023, , Pages 2-3
Abstract
Colonic injuries after blunt trauma abdomen are a rare entity which may sometimes have a delayed presentation. In the intensive care unit (ICU), various interventions like sedation, analgesia and paralysis may confoundclinical examination findings pertaining to abdominal pathology. Computed tomography ...
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Colonic injuries after blunt trauma abdomen are a rare entity which may sometimes have a delayed presentation. In the intensive care unit (ICU), various interventions like sedation, analgesia and paralysis may confoundclinical examination findings pertaining to abdominal pathology. Computed tomography (CT) provides anexcellent diagnostic modality in blunt trauma abdomen but requirement of high ventilatory support and/orvasopressors may preclude safe transfer of patients from ICU to radiology suites. Point of care ultrasound (POCUS)provides an excellent adjunct in diagnosis of hollow viscus perforation and is considered as a reliable alternative toplain radiograph for the diagnosis of pneumoperitoneum
Emergency medicine
Luis Miguel Castro; Rui Manuel Mendes; Coelho Fátima Borges; Capella Vanessa; Ávila Leonor
Volume 8, Issue 1 , January 2022, , Pages 80-82
Abstract
Objective: A Perforation of hollow viscus is the most common cause of pneumoperitoneumafter a blunt thoracoabdominal trauma and demands prompt surgical exploration.Alternative routes into the peritoneal cavity, such as the presence of a diaphragmaticlaceration associated with pneumothorax, although rare, ...
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Objective: A Perforation of hollow viscus is the most common cause of pneumoperitoneumafter a blunt thoracoabdominal trauma and demands prompt surgical exploration.Alternative routes into the peritoneal cavity, such as the presence of a diaphragmaticlaceration associated with pneumothorax, although rare, should be considered whenapproaching these patients.Case Presentation: We present the case of a 78-year-old male admitted to the emergencydepartment after being ran over by a car resulting in right thoracoabdominal trauma,presenting with dyspnea and signs of peritoneal irritation. CT scan identified rightpneumothorax, pneumoperitoneum and free abdominal fluid. The pneumothoraxwas drained and posteriorly he underwent exploratory laparotomy where a traumaticlaceration of the diaphragm was identified as the cause of pneumoperitoneum.Conclusion: Alternative causes of pneumoperitoneum should be considered in bluntthoracoabdominal trauma with possibility of conservative management in the absenceof peritoneal irritation signs. Pneumothorax drainage is mandatory before intubation toavoid creation of a tension pneumothorax.