Impact of emergency colectomy on survival of patients with fulminant Clostridium difficile colitis during an epidemic caused by a hypervirulent strain.

Objectives: To determine whether emergency colectomy reduces mortality in patients with fulminant Clostridium difficile-associated disease (CDAD), and to identify subgroups of patients more likely to benefit from the procedure.

Summary Background Data: Many hospitals in Quebec, Canada, have noted since 2003 a dramatic increase in CDAD incidence and in the proportion of cases severe enough to require intensive care unit (ICU) admission. The decision to perform an emergency colectomy remains largely empirical.

Seat-belt aorta: a rare injury associated with blunt abdominal trauma.

Seat-belt aorta, a dissection of the intima caused by direct compression of the vessel between the horizontal part of the seat belt and the vertebrae, is a rare but classical injury associated with blunt abdominal trauma. High index of suspicion is critical since this potentially lethal lesion can be asymptomatic initially. Understanding the mechanisms of injury and being aware of the frequently associated clinical signs and injuries should allow for prompt recognition and treatment without delay.