Rupture Of Vein Research Articles

Imaging findings in suspected penile fracture: alternative diagnoses and surgical correlation.

The primary objective is to compare the imaging and surgical findings in a cohort of patients with suspected penile fracture (PF). Retrospective cohort study of all patients with suspected PF over an 11-year period at a tertiary referral andrology centre. All dedicated presurgical imaging with ultrasound (US) and MRI was analysed and correlated with intraoperative findings; alternative diagnoses were recorded. One hundred and ninety-three patients were included. One hundred and four (54%) had alternative diagnoses to PF including dorsal vein rupture and haematoma. Ninety-nine (51%) underwent surgical exploration of which 89 (46%) had PF. US correctly confirmed the presence and marked the site of fracture in 92% of cases. MRI was primarily used as a problem-solving tool (13 cases) and demonstrated a more extensive injury than US (12 cases). The reported size of tunical defect on imaging was a median of 7 mm (IQR 4-10) significantly smaller than on exploration (median 20 mm, IQR 10-30; P < .0001). US has a high positive predictive value in the confirmation of PF. MRI improves the detection and characterizing the extent of injury. Imaging marking informs surgical incision but defect size is under appreciated on all imaging modalities. Penile imaging has a high positive predictive value to not only confirm the diagnosis of PF but to stage the extent of injury and mark the skin, which impacts the surgical technique. Alternative diagnoses to fracture are common and imaging could prevent unnecessary surgical exploration.

Rupture of the internal jugular vein and tension pneumothorax in a penetrating neck-lung injury due to iron splinters: a case report

Background: Penetrating neck injuries are relatively rare but pose significant challenges due to the concentration of vital structures in this area. This case report presents a unique in-stance of a 20-year-old male with a penetrating neck injury caused by iron splinters, resulting in the rupture of the internal jugular vein and tension pneumothorax.Case Presentation: The patient, a 20-year-old male, presented with restlessness, chest pain, rapid breathing, and a penetrating wound on the left side of the neck. Initial management included needle decompression for tension pneumothorax and radiological assessments to localize the foreign body. C-arm revealed that the foreign body had penetrated the upper left thoracic region and lung parenchyma. The surgical intervention involved repairing the internal jugular vein and performing pulmonary resection to remove the iron splinters.Conclusions: This case highlights the importance of a multidisciplinary approach in managing complex penetrating neck injuries. Advanced imaging techniques and timely surgical interventions are crucial for optimizing patient outcomes. Future research should focus on refining diagnostic protocols and exploring minimally invasive surgical techniques to improve the management of such injuries.

Influence of network latency and bandwidth on robot-assisted laparoscopic telesurgery: A pre-clinical experiment.

Telesurgery has the potential to overcome spatial limitations for surgeons, which depends on surgical robot and the quality of network communication. However, the influence of network latency and bandwidth on telesurgery is not well understood. A telesurgery system capable of dynamically adjusting image compression ratios in response to bandwidth changes was established between Beijing and Sanya (Hainan province), covering a distance of 3000km. In total, 108 animal operations, including 12 surgical procedures, were performed. Total latency ranging from 170ms to 320ms and bandwidth from 15-20Mbps to less than 1 Mbps were explored using designed surgical tasks and hemostasis models for renal vein and internal iliac artery rupture bleeding. Network latency, jitter, frame loss, and bit rate code were systemically measured during these operations. National Aeronautics and Space Administration Task Load Index (NASA-TLX) and a self-designed scale measured the workload and subjective perception of surgeons. All 108 animal telesurgeries, conducted from January 2023 to June 2023, were performed effectively over a total duration of 3866min. The operations were completed with latency up to 320ms and bandwidths as low as 1-5Mbps. Hemostasis for vein and artery rupture bleeding models was effectively achieved under these low bandwidth conditions. The NASA-TLX results indicated that latency significantly impacted surgical performance more than bandwidth and image clarity reductions. This telesurgery system demonstrated safety and reliability. A total of 320ms latency is acceptable for telesurgery operations. Reducing image clarity can effectively mitigate the potential latency increase caused by decreased bandwidth, offering a new method to reduce the impact of latency on telesurgery.

Splenic vein rupture in pregnancy: A case report and systematic review of the literature.

Splenic vein aneurysm (SVA) rupture is a rare clinical entity, with few case reports detailing its occurrence during pregnancy. We describe a case of a SVA rupture and present a systematic review of the literature in relation to splenic vein rupture, with or without aneurysm. Our case was of a 30-year-old woman, Para 4 at 37 weeks' gestation who presented with significant abdominal pain and subsequent maternal collapse. Massive intra-abdominal hemorrhage was identified, with splenic vessel rupture suspected. A splenectomy and partial pancreatectomy were performed along with massive blood product transfusion. There was both maternal and fetal survival with no long-term sequelae at follow-up. Histological examination of the spleen and its vessels noted a SVA rupture. In a subsequent systematic review of the literature, we identified 10 cases of splenic vein rupture with only two previously documented cases of SVA rupture in pregnancy. Maternal and fetal survival has only been reported in two cases of splenic vein rupture, with ours being a third.

Severe Head Injury with Blunt Paunch Force Trauma: A Case Report

A brain hemorrhage can occur in any part of the brain, can be caused by various conditions, both traumatic and non-traumatic. Nowadays, more and more teenagers are engaging in riskier sports either at school or in recreational settings. They are thus exposed to a variety of injuries including bruising or skull fractures. We report a case was a teenager 15 years' old that punched in a battle 1 hours ago and her friend bring him to hospital because of head swelling, that remains brain hematoma and Pneumocephalus for him. In head injuries caused by blunt trauma can also cause subarachnoid hemorrhage and subdural hemorrhage due to rupture of the superior cerebral vein and “bridging vein” due to pressure/trauma it can cause death, to distinguish subarachnoid hemorrhage from subdural hemorrhage needs to be done sprinkling with water. Traumatic brain injury is a common condition in the emergency services, affecting the pediatric and adult population significantly. Patterns of head injury as well as management principles in children are important differences compared to adults. The care of severe traumatic brain injuries is challenging and dynamic. Fortunately, with regard to the now established diagnosis of persistent TBI– Concussion, the patient now has a new treatment plan. Motor vehicle accidents are a common cause of traumatic brain injury, muscle, Spine and nerve injury. In recent years public awareness of the potential long-term effects of concussions and mild traumatic brain injuries sustained in sport of football has increased.

Fatal Hemoperitoneum Secondary to a Spontaneous Splenic Vein Rupture.

Spontaneous hemoperitoneum is rare and is often labeled as idiopathic because the source of bleeding is never found. We report the case of a 35-year-old male who died of a splenic vein rupture. The decedent was a chronic alcoholic with a reported history of cirrhosis and medication noncompliance. Internal examination revealed pale visceral organs, marked hemoperitoneum, a fibrotic/nodular liver, esophageal varices, and a ruptured splenic vein. Pertinent microscopic findings include liver parenchyma with bridging fibrous septa, nodules of regenerating hepatocytes, and the presence of Mallory-Denk bodies. The immediate cause of death was determined to be splenic vein rupture with the underlying cause of death being chronic alcoholism. This case is reported to emphasize the importance of correlating past medical history with thorough vascular dissection in cases of spontaneous hemoperitoneum. In a patient with fatal hemoperitoneum and risk factors for splenic vein pathology (ie, cirrhosis, portal vein hypertension), a high suspicion should be kept for splenic vein rupture.

Forensic characteristics of injuries from thermo-baric explosive device

Since the beginning of the Russian Federation's invasion of Ukraine in 2022, explosive trauma has become an extremely urgent problem, as the main source of bodily injury among both the military in the combat zone and the civilian population in cities has been the impact of explosive devices. The aim of the study is the examination of the forensic characteristics of damage to biological objects that were formed from thermal exposure and shock wave as a result of the explosion of a cumulative munition and in the conditions of an experimental explosion model. The objects of the study were the materials of two examinations on the death of Ukrainian soldiers who died in the war zone (archival "Conclusions of the medical examination" of the Kyiv City Clinical Bureau of Forensic Medical Examination in 2023). Under the conditions of the experiment, studies of pathomorphological changes in the liver and small intestine of 30 white outbred rats from the action of an artificially created air shock wave with an overpressure of 31.62±4.84 kPa were carried out. The injuries were examined macroscopically and using standard laboratory histological techniques. Microscopy of histological sections was performed using an Axio Imager 2 microscope (Zeiss, Germany) at magnifications of ×200 and ×400. Statistical processing of the obtained quantitative results was carried out using the STATISTICA 6.1 software product. Under the condition of the explosion of the ammunition with the cumulative effect of the rocket-propelled infantry flamethrower "Bumblebee" on sectional incisions of the skin and muscles of the thigh in the projection of areas of redness, a picture of a gelatinous consistency of bright red color was macroscopically determined due to abundant blood impregnation of muscles and subcutaneous fat and partial loss of muscle structure with the release of myoglobin. The bright red color of the skin of the thigh and pelvis without burning the hair may indicate the superficial thermal effect of the explosive device and the protection of the skin by clothing. Diffusely located numerous both paired and single abrasions and shallow wounds, small rounded, oblong, circular in shape, which are the result of fragments of a rocket-propelled grenade equipped with a fire mixture, were also determined. The effect of an air shock wave with an overpressure of 31.62±4.84 kPa on the liver parenchyma of rats was determined by focal hemorrhages with rupture of the terminal central vein of the hepatic lobule, edema of the parasinusoidal spaces, and sludges in the sinusoids. In the wall of the small intestine, acute hemodynamic disorders occurred in the form of vasodilation of arterial vessels, venular and capillary stasis. There was layering and swelling of the small intestine wall, rupture of veins, focal hemorrhage. Thus, the revealed characteristic pathomorphological signs of the destructive effect of overpressure as a result of a blast wave (barotrauma) are typical and common both in the areas of the human thigh and pelvis, and in biological objects of experimental animals. The obtained results are consistent with the pathomorphological manifestations of barotrauma in areas of the human body as a result of the action of an explosive device with a cumulative effect.

Advances in pathogenic mechanisms, diagnostic methods, surgical and non-surgical treatment, and potential recurrence factors of Chronic Subdural Hematoma: A review

Chronic Subdural Hematoma (CSDH) is a common hemorrhagic disease in neurosurgery, and with the intensification of global aging, its incidence is gradually increasing. With the advancement of scientific technology, the etiological concepts and surgical treatments for CSDH have continually evolved over time. Currently, neuroscientists' understanding of CSDH is no longer confined to bridging vein rupture; exploration of various mechanisms such as angiogenesis, maturation of blood vessels, and inflammation is also underway. In-depth exploration and discovery of pathogenic mechanisms guide the updating of clinical treatment strategies and methods. For different types of CSDH, there is now a clear guidance for the targeted selection of treatment methods. However, the current treatment of CSDH cannot completely solve all problems, and the updating of treatment methods as well as the development and validation of new effective drugs remain challenges for the future. In addition, the recurrence of CSDH is a significant issue that needs to be addressed. Although we have reviewed potential recurrent factors that may be associated, the strength of this evidence is insufficient. Future research should gradually focus on validating these recurrent factors and exploring new ones, in order to optimize the existing understanding and treatment of CSDH.

Spontaneous varicose vein rupture of the lower limb

Spontaneous varicose vein rupture of the lower limb

Vein Unveiled: An Overview of Varicose Vein

Varicose vein are enlarged, abnormally twisted veins affected by backward flow and turbulence in the blood circulation, damaging the veins,(especially of legs). Due to the incompetent nature of their valves, blood reflux frequently occurs, which can result in invenous hypertension and accompanying symptoms. It is a prevalent and often underestimated vascular condition, which continue to affect millions of people worldwide, impairing both overall health and quality of life. If progressed it results in swelling, painful lower limb, and intense itching. In severe cases, these veins rupture resulting in varicose ulcers. Various risk factors include family history, prolonged standing, older age, pregnancy, obesity. This comprehensive article aims to provide a succinct yet thorough overview of varicose veins covering the epidemiology, pathophysiology, clinical symptoms, current surgical and non- surgical treatments and the study of Unani formulation which may be useful in curing varicose vein.

A super hydrophilic and high strength chitosan hemostatic sponge prepared by freeze-drying and alkali treatment for rapid hemostasis

Excessive blood loss caused by natural accidents or major surgical procedures can be life-threatening and requires rapid hemorrhage management. Developing hemostatic materials with high water absorption capacity and high strength properties is still challenging. Super hydrophilic/high-strength chitosan hemostatic sponges (SHHS-CHS) were prepared by freeze-drying and alkali treatment. The freeze-drying technology formed a porous three-dimensional structure of sponges, and alkali treatment increased the hydrophilicity of sponges and the rigidity of the chitosan molecular chain, improving the hydrophilicity and mechanical properties of chitosan sponges. Characterization experiments revealed that SHHS-CHS had high water absorption capacity, rich pore structure, and excellent mechanical properties. The cytotoxicity and hemolysis experiments showed that SHHS-CHS had good biocompatibility. Compared to the commercial hemostatic gelatin sponges and chitosan hemostatic material, SHHS-CHS had better blood coagulation and red blood cell and platelet adhesion ability. Moreover, SHHS-CHS showed better hemostatic ability than gelatin sponges in rat-liver injury and rat leg vein rupture models, significantly reducing the hemostasis time and bleeding volume. In conclusion, SHHS-CHS has broad prospects for clinical application as a hemostatic material.

A case of vaginal varicosities without rupture after vaginal delivery

HIGHLIGHTS Vaginal varicosities are prone to happen in pregnant women with unspecific causes and multifactorial. The mode of delivery in a pregnant woman with vaginal varicosities is still unknown, but it is not an indication of caesarean section. ABSTRACT Objective: Vaginal varicose is a rare condition characterized by dilated veins in the labia majora, labia minora, and vagina. This case report reported a woman with vaginal varicose who experienced labor without any delivery complications. Case Report: The patient, a 29-year-old woman, gravida 3, para 2, presented with discomfort and swelling in the vagina at 32 weeks of gestational age. Despite reaching 39 weeks of gestation, the vaginal varicosities remained stable and painless. She had no prior history of varicose veins, hypertension, blood abnormalities, malignancy, or contraception usage. Physical examination revealed mild varicosities in the labium and significantly swollen varicosities protruding toward the vaginal introitus. Interestingly, a small varicose vein was also noted on her right leg, previously unnoticed by the patient. At 39 weeks pregnant, she experienced spontaneous vaginal delivery without complications. During the third stage of labor, the vaginal varicosities decreased in size, and no rupture occurred. The newborn, a healthy baby boy weighing 2961 grams and measuring 48 cm, was delivered vaginally. Despite a second-degree perineal tear, blood loss was minimal, and no complications nor rupture arose from the varicose veins. Conclusion: Vaginal varicosities are rare, primarily occurring in multigravida pregnant women between 12 and 26 weeks of gestation. This case highlights that cesarean section is not necessarily indicated in pregnant women with vaginal varicosities. The successful vaginal delivery in this instance resulted in no varicose vein rupture, controlled bleeding, and regression of vaginal varicosities postpartum.

Computational Modelling and Biomechanical Analysis of Age-Related Craniocerebral Injuries: Insights into Bridging Veins

The aim of this study is to explain the higher incidence of subdural haematomas in elderly people compared to young adult. This research addresses the phenomenon by developing two distinct numerical models of the human head, simulating individuals people aged 77 and 28, respectively. These models are methodically constructed based on medical imaging data acquired through collaboration with hospitals and subsequently verified through empirical experimentation. Studies have shown that the main factor that influences the vulnerability to bridging vein rupture in older adults is the degenerative processes of nervous tissue. The most visible structural damage was observed in the outflow cuff segment. This phenomenon can be primarily attributed to specific geometric parameters associated with this anatomical region. The presented research emphasises the importance of computational models in understanding the pathomechanics of brain structures. As a result of the analyses, it was proven that the neurodegenerative processes of the brain that occur with age are crucial in understanding the higher incidence of subdural haematomas in elderly people.

Uncommon case of rupture of the superficial dorsal vein of the penis

Penile dorsal vein rupture is a rare condition that affects the vascular network of the penis. It is often misdiagnosed as a penile fracture. Diagnosis can be facilitated by ultrasound of the penis coupled with Doppler or magnetic resonance imaging. Treatment options include conservative or surgical approaches. This case report presents an adult patient who presented to the emergency department with a suspected penile fracture six hours after vigorous sexual intercourse. Although a fracture of the corpora cavernosa was ruled out, an intraoperative discovery revealed a rupture of the dorsal vein of the penis. The purpose of this article is to report an uncommon case of rupture of the superficial dorsal vein of the penis.

Microvascular Decompression for Glossopharyngeal Neuralgia

Glossopharyngeal neuralgia is an extremely rare disease. Therefore, average neurosurgeons have limited number of opportunities for surgical experience of glossopharyngeal neuralgia. The authors mentioned several important surgical steps to achieve successful surgery. The initial cerebellar retraction should be modest to avoid unexpected rupture of bridging veins. The arachnoid between the lower cranial nerves and cerebellum should be fully dissected until the root entry/exit zones of all lower cranial nerves are easily observed. The offending arteries(especially the posterior inferior cerebellar artery)are tethered using arachnoid filaments. Complete dissection of the tethering arachnoid filaments is necessary for the offending artery to be mobilized and glued to the dural surface.

The Significance of Cross-Sectional Shape Accuracy and Non-Linear Elasticity on the Numerical Modelling of Cerebral Veins under Tensile Loading.

Traumatic brain injury (TBI) is a serious global health issue, leading to serious disabilities. One type of TBI is acute subdural haematoma (ASDH), which occurs when a bridging vein ruptures. Many numerical models of these structures, mainly based on the finite element method, have been developed. However, most rely on linear elasticity (without validation) and others on simplifications at the geometrical level. An example of the latter is the assumption of a regular cylinder with a constant radius, or the geometry of the vein acquired from medical images. Unfortunately, these do not replicate the real conditions of a mechanical tensile test. In this work, the main goal is to evaluate the influence of the vein's geometry in its mechanical behaviour under tensile loading, simulating the real conditions of experimental tests. The second goal is to implement a hyperelastic model of the bridging veins where it would be possible to observe its non-linear elastic behaviour. The results of the developed finite element models were compared to experimental data available in the literature and other models. It was possible to conclude that the geometry of the vein structure influences the tensile stress-strain curve, which means that flattened specimens should be modelled when validating constitutive models for bridging veins. Additionally, the implementation of hyperelastic material models has been verified, highlighting the potential application of the Marlow and reduced polynomial (of fourth and sixth orders) constitutive models.

Endoscopic evacuation of chronic subdural hematoma with rigid and flexible endoscope: case report

Introduction: Subdural haematoma (SDH) is a common neurosurgical condition after head trauma requiring evacuation to prevent secondary brain injury. The first choice of management in these patients is a large craniotomy or burr-hole evacuation. However, sometimes due to lack vision during drain tube insertion or irrigation the authors might land up in a complication like cortical bridging vein rupture, haemorrhage etc. Also, the management of septate chronic SDH (CSDH) with multiple neo-membranes does not have a well-defined surgical approach. Recently, endoscopic evacuation has been reported to a be a feasible method for evacuation in acute, subacute and chronic SDH patients. Presentation of case: A 65-years-old male patient presented with a history of recent head injury and symptoms of headache and urinary incontinence of 7 days (Glasgow Coma Scale Score 15/15). Computed tomography scan revealed CSDH at both fronto-parietal convexity more on right side. Discussion: The authors reported our initial experience on a typical case of an older patient with chronic subdural haematoma and its evacuation with the assistance of both rigid and flexible endoscope. The authors could visualize cortical bridging veins and neo-membranes intraoperatively and guided our drainage tube accordingly to avoid inadvertent haemorrhage. There was no recurrence of symptoms postoperatively. Thus we achieved apparent successful evacuation of the CSDH in this patient in a 6-month follow-up. Conclusion: Endoscopic evacuation of CSDH proves to be an effective minimally invasive modality and more studies are required on larger patient groups with long-term follow-up imaging to confirm its superiority.

Superficial dorsal penile vein rupture mimicking penile fracture

Introduction: Superficial dorsal penile vein rupture is a rare penile emergency that mimics penile fracture. Many times, diagnosis will be uncertain as they both have similar symptoms and signs. Delay in treatment of penile fracture can lead to long-term sequelae like erectile dysfunction and thus prompt diagnosis and treatment are required. Case Report: We report a case of a 35-year-old male patient with acute penile swelling and ecchymosis which developed during sexual intercourse suggesting penile fracture. Surgical exploration revealed rupture of superficial dorsal penile vein and no corporal injury. Hematoma was evacuated and vein was ligated. The patient had a good prognosis and reported maintained erectile function. Conclusion: Superficial dorsal penile vein rupture is a rare penile emergency which usually has similar clinical features of penile fracture and hence called false penile fracture. If diagnosis is uncertain, surgical exploration is recommended for definitive diagnosis and to prevent potential long-term sequelae of untreated penile fracture.

A chronic subdural hematoma complicating an arachnoid cyst in a juvenile boxer: a rare case report with comprehensive literature review

Introduction and importance: Arachnoid cyst (AC) is the most frequently founded lesion reported in adolescent patients suffering from chronic subdural haematoma (CSDH). Association between these two distinct clinical entities is known for a long time. However, in the literature there are numerous clinical cases that reflect this relationship and few large series that analyze them in detail. Paediatric population is more rarely affected with this association. Case presentation: The authors report the case of AC of incidental discovery complicated with CSDH in 15-year-old male recreational boxer presented with progressive onset of holocranial drug-resistant throbbing headache with favourable clinical course after conservative treatment. Clinical discussion: ACs are a well-known predisposing cause for CSDH after head trauma. In all cases of CSDH in children, the diagnosis of ruptured AC should be considered. Rupture may be spontaneous or following even mild head trauma with rupture of bridging veins causing subdural bleeding as it was seen in our patient who was practicing a full-contact free-sparring sport like boxing sustaining repeated and direct mild head traumas. MRI is recommended to detect small cysts in adolescents with CSDH. The management of these patients remains controversial. Conclusion: This is a rare reported case of CSDH complicating an AC in a juvenile recreational male boxer. This association remains extremely rare in children and adolescents, as evidenced by the rare cases reported in the literature.

Idiopathic omentum hemorrhage as a cause of hemoperitoneum

Hemorrhage into the large omentum is a general term for a pathological condition in which an omental artery and/or vein ruptures with bleeding into the abdominal cavity and/or forming an omental hematoma. There is a high probability of its diagnosis only during surgery. This is an extremely rare condition, which is described only in clinical case reports. There are primary and secondary omental hemorrhage. Secondary hemorrhage occurs due to various reasons, primary (idiopathic) in the absence of morphological changes that could lead to bleeding to the large omentum. The article is devoted to a rare case of idiopathic omentum bleeding complicated by hemoperitoneum, diagnosed intraoperatively. The article presents the results of a literary review of the last twenty years on English-language and Russian-language publications on omental hemorrhage, presented in the databases of PubMed and the Russian scientific electronic library (eLIBRARY.RU). According to the results of the analysis of the literature data, ultrasound can be used as a first-line imaging method to assess the presence of hemoperitoneum. But CT angiography is the method of choice in assessing acute intra-abdominal bleeding and determining the cause of bleeding due to its speed, availability and ability to diagnose alternative causes of abdominal pain, and it is also recommended to be performed in cases where ultrasound data do not allow to unambiguously establish the presence of bleeding or localize its source. Also, taking into account the age characteristics and gender of patients, the presence of bleeding into the omentum may be due to conditions such as cystic lymphangioma and interrupted ectopic pregnancy. Other causes may be vascular pathologies, tumors and anticoagulant therapy. When detecting signs of bleeding into the large omentum, in addition to determining the fact of hemoperitoneum and its volume, the most important tasks are to establish the causes of hemorrhage and differential diagnosis between idiopathic and secondary bleeding.