The Pan African medical journal
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Observational Study
Acid-base disorders as predictors of early outcomes in major trauma in a resource limited setting: An observational prospective study.
Mortality from trauma remains a major challenge despite recent substantial improvements in acute trauma care. In trauma care patient resuscitation to correct hypotension from volume loss still majorly relies on use of physiological parameters such as blood pressure, pulse rate, respiratory rate, urine output and oxygen saturation. In resource limited settings these methods may not be sufficient to detect occult tissue hypoxia and the accompanying metabolic derangements. ⋯ Metabolic acidosis is common among major trauma patients, its severity may be related to delay in initiating care. Acid base derangements were predictors of mortality among major trauma patients in this resource limited setting.
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Case Reports
Retropharyngeal abscess revealing a migrant foreign body complicated by mediastinitis: a case report.
Pharyngeal foreign bodies are quite common. Their diagnosis is usually easy. The risk of complications including retropharyngeal abscess and mediastinitis is rare and it depends mainly on the nature of the foreign body and the period of the therapeutic management. ⋯ The outcome was favorable clinically and biologically. Pharyngeal foreign bodies are common and favorable when the diagnosis and extraction are made on time. The occurrence of complications, especially retropharyngeal abscess and mediastinitis is rare and burdened with a high morbidity and mortality.
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Splenosis is a benign condition among patients with a history of splenic trauma or surgery. Most cases of splenosis are intra abdominal due to direct seeding of surrounding structures, although these heterotopic rests may occur almost anywhere in the body, and its diffuse nature may raise the suspicion of metastatic cancer. The increased prevalence of abdominal trauma due to road accidents and the growing armamentarium of available imaging modalities suggest that abdominal splenosis may be expected more often than ever. We, in this article emphasize the crucial role of taking a thorough patient's medical history concerning splenic trauma in the past and the use of novel non invasive diagnostics modalities that allow accurate diagnosis.
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Sternoclavicular joint dislocation is a rare event. It occurs most often in a violent trauma. The authors report the case of a10 years old child, received at emergencies for right shoulder blunt trauma after been punched by another child. ⋯ After 18 months, the shoulder was painless and mobile in all directions. It is an isolated recent posterior sternoclavicular joint dislocation in a child. With this observation the authors emphasizeon the unusual mechanism of such a dislocation occurrence, the primary role of CT scan in the diagnosis and early closed reduction.
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Forestier's disease, also known as diffuse idiopathic skeletal hyperostosis (DISH), is a pathology of vertebral bodies characterised by exuberant osteophytis formation. Forestier's disease is usually managed conservatively. ⋯ He was managed successfully with an anterior cervical osteophytectomy without fusion. A literature review is included.