Acta clinica Croatica
-
Acta clinica Croatica · Jun 2022
Case ReportsBLUNT TRAUMA INTERCOSTAL LUNG HERNIATION AND DELAYED EXTRA PLEURAL HEMATOMA.
Blunt chest trauma is an important cause of morbidity and mortality in traumatized emergency patients. We report the case of a 74-year-old man who suffered a glenohumeral joint dislocation, trans trochanteric femur fracture, multiple rib fractures, diaphragmatic rupture with chest herniation of the spleen and stomach associated with herniation of the lung through an anterior chest wall defect after blunt trauma. Although immediate surgical repair was performed, he developed a delayed complication of multiple rib fracture in the form of large extrapleural hematoma that had to be surgically removed. Due to massive pulmonary contusion and prolonged pulmonary collapse, we used surfactant to facilitate alveolar opening after evacuation of the hematoma.
-
Acta clinica Croatica · Jun 2022
VENOUS THROMBOEMBOLISM IN THE EMERGENCY DEPARTMENT - SINGLE-CENTER EXPERIENCE.
Given the importance of early recognition of acute venous thromboembolism (VTE) and the nonspecificity of its symptoms and signs, it is essential to follow the guidelines for diagnostic and therapeutic decisions. Ultrasound examination of the entire lower extremity is currently the standard diagnostic method for symptomatic patients with a clinical probability of deep vein thrombosis (DVT) according to the Wells scoring system. The aim of this study is to show the demographic structure and analyze the number of patients in the emergency department with suspected venous thrombosis. ⋯ The presence of thrombi above the knee, involving the deep femoropopliteal venous system, was found in as much as one-third of patients. These findings and current guidelines suggest that there is a paradigm shift toward more frequent use of DOAC in patients with DVT. However, greater educational efforts may be needed for many physicians to become comfortable with the use of DOAC in the outpatient management of patient populations at low risk for pulmonary embolism.