Items tagged “trauma”

Esophageal perforation is a rare but serious medical emergency with a very high mortality rate, especially if the diagnosis is delayed. Epidemiology Most patients are in their sixties with a slight male predominance 5.  Clinical presentation Esophageal rupture is iatrogenic from instrumentat...

Trauma is a leading cause of mortality in pregnancy. Pregnancy increases the incidence and severity of abdominal trauma in females.  Epidemiology Trauma affects up to 7% of pregnancies, and the incidence of pregnancy in level 1 trauma patients is estimated to be ~2% 1.  Pathology Etiology 9...

The liver is one of the most frequently damaged organs in blunt trauma, and liver trauma is associated with a significant mortality rate. Epidemiology In blunt abdominal trauma, the liver is injured ~5% (range 1-10%) of the time 1,3. Clinical presentation Patients can present with right uppe...

Splenic trauma can occur after blunt or penetrating trauma or secondary to medical intervention (i.e. iatrogenic). The spleen is the most frequently injured internal organ after blunt trauma. Epidemiology In blunt trauma, the spleen can account for up to 49% of abdominal organ injuries 2. Cli...

Adrenal gland trauma most commonly results from blunt force trauma. Epidemiology Adrenal gland trauma is present on 1-2% of CT imaging in blunt trauma although the occurrence is thought to be much higher as injury has been demonstrated at 28% in one autopsy series 1-4.  The right adrenal glan...

Bowel and mesenteric trauma can result from blunt force, penetrating and iatrogenic trauma. CT is the gold standard imaging modality but CT findings are nonspecific 12. Epidemiology The bowel and mesentery are injured in ~2.5% (range 0.3-5%) of blunt force abdominal trauma 1,3,5,8. However not...

Isolated free fluid in trauma may or may not represent a significant injury, and this creates a diagnostic dilemma in determining appropriate treatment for these patients.  Epidemiology The presence of isolated free fluid in trauma occurs in 3-5% of blunt trauma patients 1-4. Pathology The c...

The pancreas is uncommonly injured in blunt trauma. However, pancreatic trauma has a high morbidity and mortality rate. Epidemiology The pancreas is injured in ~7.5% (range 2-13%) of blunt trauma cases 1,3,7. Motor vehicle accidents account for the vast majority of cases. Penetrating trauma co...

Sternal fractures occur in ~5% of blunt chest trauma with the manubrium being the most commonly injured part. Epidemiology Fractures of the sternum are seen in between 3-6.8% of all motor vehicle collisions 1. Cardiopulmonary resuscitation (CPR) often results in sternal fractures, one autopsy...

Aortic pseudoaneurysm typically occurs as a result of trauma +/- intervention, and is considered a subset of traumatic aortic injury in the majority of cases. They can be acute or chronic. Pathology Aortic pseudoaneurysms are contained ruptures of the aorta in which the majority of the aortic ...

Proximal femoral fractures are a subset of fractures that occur in the hip region. They tend to occur in older patients, and in those who have osteoporosis. In this group of patients, the fracture is usually the result of low-impact trauma although, in younger patients they are usually victims o...

Bucket handle fractures of the pelvis are a result of anteroposterior compression energy vectors. It is described as a vertically-oriented fracture through ipsilateral superior and inferior pubic rami with contralateral sacroiliac joint disruption/dislocation 1, 2. See also pelvic fractures b...

Ureteric injury is a relatively uncommon, but severe event, which may result in serious complications as a diagnosis is often delayed.  Clinical presentation Ureteric injuries unreliably demonstrate macro- or microscopic hematuria as it may be absent in up to 25% of patients 5, 6. Classic clin...

The aubergine sign (also known as egg-plant sign or deformity) is a clinical sign of a fractured penis. Hemorrhage beyond the tunica albuginea produces swelling and bruising of the penis simulating the appearance of an aubergine.  

The thoracolumbar injury classification and severity score (TLICS), also sometimes known as the thoracolumbar injury severity score (TISS), was developed by the Spine Trauma Group in 2005 to overcome some of the perceived difficulties regarding the use of other thoracolumbar spinal fracture clas...

Rib fractures are a common consequence of trauma and can cause life-threatening complications. Epidemiology Associations Rib fractures are often associated with other injuries and the greater the number of rib fractures the more likely are associated injuries 1,3: brachial plexus or subclavi...

Rhabdomyolysis describes the breakdown of striated muscles with the release of intracellular contents and represents a severe muscle injury. MRI is the imaging modality of choice. Rhabdomyolysis is potentially life-threatening although recovery is excellent with early treatment. Clinical presen...

The seatbelt sign is both a clinical and radiological sign. It is simply the presence of ecchymosis and/or abraded skin in the distribution of a seatbelt (i.e. horizontal and/or diagonal) extending across the abdomen evident after a motor vehicle accident. Epidemiology A positive abdominal sea...

Spinal wedge (compression) fractures are hyperflexion injuries to the vertebral body resulting from axial loading. Most commonly affecting the anterior aspect of the vertebral body, wedge fractures are considered a single-column (i.e. stable) fracture.  Terminology Less commonly wedge fracture...

There are many types of talar dislocation given its multiple articulations: tibiotalar dislocation subtalar dislocation total talar dislocation talonavicular dislocation ​Chopart fracture-dislocation