Unusual cause of haemorrhage from surgical wound in a child

Haemorrhage from a surgical wound can be from many potential sources such as injury to vessel, muscle and bone; bleeding disorders; incomplete haemostasis; pseudoaneurysm; and neovascularisation. We report an unusual cause of haemorrhage from the surgical incision in a 9-year-old child. We emphasize that a high index of suspicion is required for early diagnosis, and pseudoaneurysm and neoangiogenesis should be considered in the differential diagnosis of soft tissue masses resulting from direct, blunt trauma even in children

Evaluation of Traumatic Spine by Magnetic Resonance Imaging and Correlation with Neurological Recovery

Study DesignProspective study.PurposeTo compare magnetic resonance imaging (MRI) findings with clinical profile and neurological status of the patient and to correlate the MRI findings with neurological recovery of the patients and predict the outcome.Overview of LiteraturePrevious studies have reported poor neurological recovery in patients with cord hemorrhage, as compared to cord edema in spine injury patients. High canal compromise, cord compression along with higher extent of cord injury also carries poor prognostic value.MethodsNeurological status of patients was assessed at the time of admission and discharge in as accordance with the American Spine Injury Association (ASIA) impairment scale. Mean stay in hospital was 14.11±5.74 days. Neurological status at admission and neurological recovery at discharge was compared with various qualitative cord findings and quantitative parameters on MRI. In 27 patients, long-term follow-up was done at mean time of 285.9±43.94 days comparing same parameters.ResultsCord edema and normal cord was associated with favorable neurological outcome. Cord contusion showed lesser neurological recovery, as compared to cord edema. Cord hemorrhage was associated with worst neurological status at admission and poor neurological recovery. Mean canal compromise (MCC), mean spinal cord compression (MSCC) and lesion length values were higher in patients presenting with ASIA A impairment scale injury and showed decreasing trends towards ASIA E impairment scale injury. Patients showing neurological recovery had lower mean MCC, MSCC, and lesion length, as compared to patients showing no neurological recovery (p<0.05).ConclusionsCord hemorrhage, higher MCC, MSCC, and lesion length values have poor prognostic value in spine injury patients

Role of CT in evaluating upper aerodigestive tract injuries

This study was aimed to assess the role of CT in upper aerodigestive tract injuries. Twenty six patients presenting with upper aerodigestive tract injury were examined by CT. Nineteen patients had blunt trauma to the neck while seven had penetrating injury. Most of the patients presented soon after injury. Symptoms included respiratory distress (14), neck tenderness (18), hoarseness (7), haemoptysis (2) and odynophagia (3). Soft tissue injuries were seen in 8 patients, aryepiglottic fold edema in 4, aryepiglottic fold haematoma in 1, vocal cord edema in 2 and pyriform sinus obliteration in 5 patients. Supraglottic injuries were seen in six patients, glottic injury in 8 patients and subglottic injuries in 4 patients. Tracheal injuries were seen in 8 patients and included cricotracheal separation (1), tracheal tears (5) and tracheal narrowing (4). Hypopharyngoesophageal injuries were seen in 2 patients. CT was helpful for localization of foreign bodies in 2 cases. CT is useful in deciding management of patients with upper aerodigestive tract injuries obviating the need of open exploration in patients with minimal mucosal injuries, undisplaced fracture and sealed tears. It is particularly helpful in cases when indirect laryngoscopy was not possible. (Med J Indones 2006; 15:81-9) Keywords : Aerodigestive tract injuries, tracheal injuries

Pneumothorax: A rare presentation of pulmonary mycetoma

Pneumothorax due to mycetoma is extremely rare and has been described only in patients undergoing intensive cytotoxic therapy for hematologic malignancies. A non-immunocompromised subject presenting with pneumothorax due to rupture of the mycetoma into the pleural cavity is being described here

Computed tomography based staging in the carcinoma of the larynx

[no abstract available