BACKGROUND Our objective was to assess the cost-effectiveness of emergency department thoracotomy (EDT) performed on both penetrating and blunt trauma victims, using both published survival and outcome data and previously unaccounted for data on the cost of occupational exposure. METHODS Cost-utility analysis was performed using decision-analytic models constructed for both penetrating and bl...

BACKGROUND Abdominal computed tomographic (CT) scan is accepted as the primary diagnostic modality in stable patients with blunt abdominal trauma. A recent survey of 328 trauma surgeons demonstrated marked variation in the management of patients with head injuries and the finding of free intra-abdominal fluid without solid organ injury on CT scan. This study was undertaken to attempt to determi...

47 January 2015, Vol. 105, No. 1 Trauma is a leading cause of death in the developing world, and represents a major burden of disease in South Africa (SA).[1,2] Children are disproportionately affected.[3] Blunt trauma secondary to motor vehicle collisions (MVCs) contributes to the majority of admissions to trauma centres.[4] Significant blunt thoracic trauma in both adults and children require...

Blunt injury to the chest can affect any one or all components of the chest wall and thoracic cavity. The clinical presentation of patients with blunt chest trauma varies widely and ranges from minor reports of pain to florid shock. Traumatic tricuspid valve regurgitation is a rare cardiovascular complication of blunt chest trauma. Tricuspid valve regurgitation is usually begotten by disorders ...

Failure to recognize popliteal artery injury and restore vessel continuity of flow after blunt trauma is a major cause of lower extremity amputation and morbidity. A high index of suspicion and early recognition of the injury are paramount for limb salvage. We experienced a rare case of poplitial artery occlusion with the presence of arterial pulses due to collateral circulation after blunt tra...

INTRODUCTION Electrocardiogram (ECG) abnormalities in patients with blunt chest trauma are diverse and non-specific, but may be indicative of potentially life-threatening conditions. CASE PRESENTATION We report a rare case of pneumopericardium with extreme ECG abnormalities after blunt chest trauma in a 22-year-old male. The diagnosis was confirmed using computed tomography (CT) scanning. The...

T raumatic blunt injury to the thoracic aorta is a devastating condition that can lead to immediate death at the time of injury in the majority of cases, due in part to either aortic transection or acute rupture.1 Although blunt aortic injury accounts for fewer than 1% of all adult level I trauma center admissions, this condition represents the second most common cause of death due to blunt inj...

INTRODUCTION — Blunt chest trauma puts multiple structures at risk of injury. In addition to direct trauma, rapid deceleration and other mechanisms can cause injury to thoracic structures. Major concerns include chest wall injury, such as rib fractures or flail chest, cardiovascular injury, such as blunt aortic injury or cardiac contusion, and pulmonary injury, such as contusions or lacerations...

BACKGROUND Major bile leak after blunt liver trauma is rare but challenging. It usually requires endoscopic retrograde cholangiography (ERC) for management. However, there is still lack of specific indications. The aim of this study is to elucidate risk factors for major bile leak and indications for early ERC after blunt liver trauma. METHODS The trauma registry of a level I trauma center in...

BACKGROUND Canadian trauma units have relatively little experience with major cardiac trauma (disruption of a cardiac chamber) so injury outcome may not be comparable to that reported from other countries. We compared our outcomes to those of other centers. METHODS Records of patients suffering major cardiac trauma over a nine-year period were reviewed. Factors predictive of outcome were anal...