Infrarenal aortic dissection in a child after blunt trauma.

We present a 4-year-old who suffered blunt abdominal trauma leading to Chance fractures to the lumbar spine, bucket-handle injuries to the ileum and descending colon, and an aortic intimal injury leading to occlusion of the infrarenal aorta with extension to the bifurcation. Her vascular injuries were managed by endarterectomy of the intimal injury, thrombectomy of the distal aorta and bilateral iliac arteries using a Fogarty catheter, and patch angioplasty of the infrarenal aorta using bovine pericardium secured by a combination of interrupted and running sutures to optimize elasticity and operative time.

Analysis of Predictors of Myocardial Infarction in Trauma With Development of a Trauma Cardiac Risk Index.

Study Objective: Trauma has historically been considered a disorder of the young and healthy, with a low risk of cardiac ischemia; hence most research on myocardial infarction in trauma has focused on direct cardiac damage from blunt chest trauma. However, the age and comorbidity of trauma patients are increasing, making the trauma population more vulnerable to myocardial infarction (MI). Cardiac risk assessment has emphasized morbidity and mortality in an elective surgical setting, but it is also important in acute trauma.

Neurologic manifestations in anaphylaxis due to subcutaneous allergy immunotherapy: A case report.

Rationale: Life-threatening anaphylactic shock is a rare (1 in 1 million) but documented occurrence in response to subcutaneous immunotherapy. Immediate administration of Epinephrine (Epi) is critical to save lives in these situations. The current protocol for systemic reactions in immunotherapy is for the prescribing physician to reassess the dosing and schedule as well as the risk:benefit assessment for the therapy and determine whether or not to proceed.