Journal of Emergency Medicine, Trauma and Acute Care - Volume 2012, Issue 1

Abstract All terrain vehicle (ATV) use is increasing at a rapid pace in settings without proper safety regulations. Aim: To define injury patterns, impairments, and outcomes among patients injured in ATV crashes; to determine prevalence of protective equipment use; and to define the potential role of injury prevention in addressing the problem. Methods: During a recent 10 month period, 56 patients were reported as injured in ATV c Read More

Abstract Snakebites are a common environmental hazard in many regions of the world. The objectives were to study the epidemiology, clinical, laboratory features of snakebites, the pattern of management with its outcome, and studying the association between the presenting clinical and initial laboratory findings with the outcome. Method: a retrospective, hospital-based study was conducted from March 1997–April 2001 at the Saudi Read More

Subclavian artery injuries are rare in blunt chest trauma, constituting just 1–2 percent of all acute vascular injuries. The diagnosis of injury to the subclavian artery is challenging as a good percentage of patients with such vascular injuries have palpable distal pulses, no signs of any external local trauma and associated injuries often divert the attention of treating physicians. Subclavian artery injuries are the second most common injuri Read More

Abstract Objective: The objective of this study was to analyze cases that had left the Pediatric Emergency Center Al Sadd, Doha (PEC) against medical advice, with the aim of developing policies to help reduce this occurrence. Methodology: All patients that were admitted to the main PEC observation room for treatment and/or investigation and subsequently left against medical advice from February 18, 2007 to June 18, 2007, were followe Read More

Abstract Tracheobronchial disruption is an uncommon injury usually associated with severe blunt thoracic trauma. It rarely occurs in isolation. We report a case of isolated avulsion of the right main bronchus occurring after a high-speed car collision with severe head injury. Management of this condition is briefly discussed.

Abstract Malignancy in undescended testis is well documented. We present a rare case—of seminoma in an adult male found in an intra abdominal testis—that is associated with ipsilateral renal agenesis and absence of ipsilateral seminal vesicle.

Abstract We report a case of a sixty-two-year-old man who presented to the emergency department with severe right iliac fossa pain. The patient was clinically diagnosed as having acute appendicitis and was referred for an abdominal CT scan. Abdominal CT revealed a Spigelian hernia with Richter-type herniation of the small bowel without any significant bowel obstruction. The patient underwent immediate surgical repair and the postoperati Read More

Abstract We report a case of Bochdalek hernia of the diaphragm in an adult who presented with acute upper abdominal pain and vomiting. We report this case because it is a rare condition, with little more than 100 cases reported in the literature [1]. Moreover, this is a condition mostly found in neonates and children, rarely carrying over into adulthood. This case details how to recognize the condition and how a lack of awareness aro Read More

Abstract We report a case of bilateral Purtscher’s retinopathy in a young man following a motor vehicle rollover accident. Decreased vision was noticed on the fifth day following the trauma. Visual acuity in the right eye was close counting finger, and left eye, counting finger one meter. There was no evidence of direct ocular, head or facial trauma. Purtscher flecken, pre-retinal and retinal hemorrhages were present in both eyes. The right Read More

Abstract Intrathoracic bleeding may occur following blunt chest trauma, and can be classified as minimal, moderate or massive, according to the amount of blood present. The diagnosis of hemothorax is established by clinical examination, plain chest radiograph or, more recently, by ultrasound of the chest [1]. Computed tomography of the chest helps to define the nature of the chest injury but is not indicated in all patients because of l Read More

Abstract Background: The natural history and optimal management of retained hemothorax (RH) after chest tube placement is unknown. The intent of our study was to determine practice patterns used and identify independent predictors of the need for thoracotomy. Methods: An American Association for the Surgery of Trauma multicenter prospective observational trial was conducted, enrolling patients with placement of chest tube within 2 Read More

Abstract Background: Percutaneous tracheostomy is a routine procedure in the intensive care unit (ICU). Some surgeons perform percutaneous tracheostomies using bronchoscopy believing that it increases safety. The purpose of this study was to evaluate percutaneous tracheostomy in the trauma population and to determine whether the use of a bronchoscope decreases the complication rate and improves safety. Methods: A re Read More

We present the case of a 25 year-old man who had a splenectomy five years previously following a road traffic accident (RTA). He presented to our A&E department one evening with fever and upper abdominal pain associated with nausea & vomiting. Clinical examination was unremarkable. Initial investigations revealed only pyuria. He was treated symptomatically along with parenteral antibiotic and admitted to the general medical war Read More

Angioedema is a rare but potentially life threatening condition commonly associated with angiotensin-converting enzyme inhibitors (ACEIs). The incidence is approximately 0.1–0.2% and may occur within the first week to several years of taking an ACEI. We present a case of a 37-year-old African American male who was uneventfully taking a drug combination of quinapril and hydrochlorothiazide. When his medication was changed to li Read More

Objectives: To assess urinary calculi and the secondary signs of obstruction, in patients referred from the accident and emergency department, by unenhanced computed tomography examination and to review the radiation dose the patients received with the use of automatic dose modulation technique, care dose 4D. Material and methods Medical records of unenhanced multi-slice computed tomography (MSCT) examinations for 1 Read More

Objectives: To determine the factors associated with a poor final visual outcome following a non-perforating traumatic hyphema. Methods: The in-patient records of all traumatic hyphema patients admitted to the Department of Ophthalmology of the Hamad Medical Centre (HMC) in Doha, Qatar, were retrospectively reviewed for a four-year period from January 2004 to March 2008. One hundred and seventeen patients who did not meet th Read More

Abstract Background: Safety data on recombinant activated factor VII (rFVIIa, NovoSeven; Novo Nordisk A/S, Bagsværd, Denmark) in actively hemorrhaging trauma patients are limited. We present detailed safety data from a large multicenter, randomized, placebo-controlled phase III study (the CONTROL trial). Methods: Data from 560 patients were analyzed. Subjects were monitored for adverse events (AEs) after rFVIIa or place Read More

We report a 45 year-old male patient who presented to the emergency department of Hamad General Hospital with recurrent severe low back pain. Clinical examination revealed characteristic deposition of blue-brownish pigment in the sclera and ear. X-ray revealed diffuse intervertebral disc calcification. Alkaptonuria was suspected and the diagnosis was confirmed by detection of high levels of homogentisic acid in the urine.

Abstract Sigmoid volvulus is an important surgical emergency which requires rapid detorsion of the affected bowel. Prompt diagnosis is crucial. It should be one of the differentials to be considered in patients presenting with abdominal distension and signs of intestinal obstruction. This case presentation serves to highlight one such example; the clinical presentation, radiological findings and management are discussed.

Traffic accidents resulting from the collision of motor vehicles with wildlife occur worldwide. In the United States, Canada, Europe, the Middle East and Australia these collisions usually involve deer, moose, camels and kangaroos. Because these are large animals, the collisions are frequently associated with high morbidity and mortality rates. Camel-vehicle collisions in the Middle East—especially Saudi Arabia—have risen to such disturbing pr Read More