J Trauma
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Case Reports
Transcutaneous balloon catheter tamponade for definitive control of subclavian venous injuries: case reports.
Two cases are presented in which transcutaneous balloon catheter tamponade of exsanguinating infraclavicular injuries was performed in the trauma admitting area. Angiography and venography demonstrated isolated injuries of the subclavian vein tamponaded by the balloon catheter. Balloon catheter tamponade provided emergency control of bleeding in the admitting area and ultimately definitive treatment of the venous injury.
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Serum levels of interleukin-6, interleukin-8, the soluble receptor for tumor necrosis factor (sTNFr), and the soluble receptor for intercellular adhesion molecule-1 (sICAM-1) were measured serially in a series of 13 severely injured trauma patients to determine if any of these elements of the inflammatory response are predictive of multiple organ failure (MOF). Six of the 13 patients developed MOF as determined by a MOF scoring system. ⋯ There was a significant correlation between the absolute level of sICAM-1 at the time of resuscitation and the severity of subsequent MOF. This finding suggests that leukocyte-endothelial cell interactions are upregulated immediately after injury and may be implicated in the end-organ injury that leads to MOF.
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Case Reports
T-tube intubation in the management of late traumatic esophageal perforations: case report.
Delayed diagnosis of esophageal perforations can lead to high mortality and morbidity and presents a surgical dilemma. A case report of a bullet wound of the esophagus that was diagnosed late is presented. Placement of a biliary T-tube and pleural decortication were carried out after the perforation was found at esophagoscopy. The patient had no fistula nor esophageal narrowing at discharge 31 days after injury.