Mild Abdominal Trauma Research Articles

Delayed splenic rupture in massive splenomegaly - a case report

Introduction. We present a patient with a delayed rupture of the spleen following a mild abdominal trauma. For years, the patient was treated for hereditary massive splenomegaly with thrombocytopenia, without established etiology. Case Report. The initial non-operative treatment lasted seven days, after which the patient was readmitted to the Emergency Department with signs of intra-abdominal hemorrhage and underwent emergency open splenectomy. Even after pathohistological examination, the etiology of massive splenomegaly remained unknown. Conclusion. Conservative treatment is not recommended in cases of massive splenomegaly; thorough surgical observation in a tertiary care hospital with interventional radiology and a good multidisciplinary team is necessary, while splenectomy is a surgery of choice.

Angioedema associated with dihydropyridine calcium-channel blockers in a child with Burkitt lymphoma

A case of severe macroglossia and angioedema in a child with Burkitt lymphoma who was treated with two dihydropyridine calcium-channel blockers is reported. An eight-year-old white boy arrived at the pediatric emergency department with complaints of abdominal pain and distention after an episode of mild abdominal trauma. Physical examination results were significant for diffuse abdominal tenderness and distention, with a large palpable mass in the right quadrants. Computed tomography revealed a large abdominal mass, and a biopsy confirmed a diagnosis of Burkitt lymphoma. Before initiation of chemotherapy, the child developed tumor lysis syndrome, with subsequent renal failure and cardiorespiratory compromise. Once the patient was stabilized and sedated on mechanical ventilation, tumor-directed chemotherapy was initiated, and rapid tumor regression ensued. To control episodes of hypertension, nicardipine was initiated and titrated to achieve the blood pressure goals. Three days after initiation of nicardipine therapy, the child developed facial swelling and significant, protruding macroglossia. Eight days after nicardipine initiation, a tracheotomy was required due to upper airway obstruction; at that time, the patient was converted to amlodipine administered via nasogastric tube for continued blood pressure control. The boy's macroglossia persisted for another 18 days, until a multi-disciplinary drug therapy review resulted in the discontinuation of amlodipine. Within one week of the withdrawal of amlodipine, the child's macroglossia was completely resolved. An eight-year-old boy with Burkitt lymphoma developed severe macroglossia and angioedema when treated with nicardipine. The reaction persisted throughout treatment with amlodipine and resolved quickly after amlodipine was withdrawn.

Massive per rectal bleeding following blunt abdominal trauma: First presentation of Crohn's disease

IntroductionInflammatory bowel disease is a chronic and relatively common disorder with heterogeneous presentation. Peak incidence occurs in the second and third decades of life. We present a patient with Crohn's disease whose first presentation was profuse bleeding/rectum following blunt abdominal trauma. presentation of caseA 29 year old previously healthy man presented one hour after sustaining relatively mild abdominal trauma, due to fall onto the ball during a rugby match. He complained of abdominal pain and one episode of large fresh rectal bleeding. He was pale and distressed with hypotension, tachycardia and abdominal guarding & fresh blood on digital rectal examination. With a provisional diagnosis of intestinal injury he was taken to theatre. Right hemi-colectomy was done for a thickened and inflamed segment of distal ileum, a large adjacent mesenteric haematoma & mesenteric lymph nodes and blood in distal bowel. Histology confirmed the features of Crohn's disease. discussionCrohn's disease is unusual cause of massive lower gastrointestinal bleeding occurring in 0.9–6% of patients. Rectal bleeding associated with diarrhoea is relatively more common than massive bleeding. The presence of Crohn's disease in young patients presenting like this is unlikely to be suspected and diagnosis could only be made after laparotomy.

Colonic perforation following mild abdominal trauma in a patient with Crohn's disease: a case report

Colonic perforation following mild abdominal trauma in patients with Crohn's disease is a rare occurrence. We present a case of a 21 year old Crohn's sufferer, who presented to the emergency department with signs of shock and peritonitis following minor abdominal trauma. A computed tomography (CT) scan revealed ascending colonic perforation and he underwent a subsequent right hemicolectomy. This is the first UK report of a patient with inflammatory bowel disease suffering colonic perforation following minimal trauma.

Small Bowel Perforation Due To Blunt Abdominal Trauma Associated With Right Inguinal Hernia: Report of a case

Inguinal hernias are common surgical pathologies with well known complications. Bowel perforation resulting from abdominal trauma in association with inguinal hernia is a rare complication. We report a case with three years follow-up of a patient with right inguinal hernia and small bowel perforation due to mild abdominal trauma, treated by laparotomy, suture of the intestinal perforation and one-stage transabdominal hernioplasty.

Fetal bilateral subdural haemorrhages. Prenatal diagnosis and spontaneous resolution by time of delivery

We report a patient diagnosed prenatally on routine fetal ultrasound, at 30 weeks' gestation, with subdural haemorrhage. The mother had suffered a mild abdominal trauma and had Factor XI deficiency; however, both were felt to be aetiologically insignificant. Prenatal follow-up showed a complete resolution of the haematoma and no postnatal sequelae have been noted to date. The aetiologies and outcomes in the few previously reported cases are reviewed and compared with our case.

Diaphragmatic hernia masquerading as pneumothorax in two toddlers

In two separate incidents, two toddlers with no previous history of respiratory ailments presented to the emergency department of a children's hospital with progressive respiratory distress. Both children had unilateral lung findings on auscultation and initial chest radiographs that were consistent with a pneumothorax. Thoracostomy and chest tube insertion were performed during initial resuscitation efforts. In both cases, subsequent radiographs revealed that the stomach was located in the left hemithorax, suggestive of a diaphragmatic hernia. Nasogastric tube insertion relieved the respiratory distress of these two children. Recognition of the "acquired" congenital diaphragmatic hernia in the setting of extreme aerophagia or mild abdominal trauma may prevent unnecessary procedures during the resuscitation of children with acute respiratory distress and unilateral lung findings.