Unusual case of life threatening subcutaneous hemorrhage in a blunt trauma patient

International Journal of Surgery Case Reports
Ashraf F HefnyNabil N Al Khoury

Abstract

Hemorrhage is the most common cause of shock in injured patients. Bleeding into the subcutaneous plane is underestimated cause of hypovolemic shock. Unrestrained male driver involved in a rollover car crash. On examination, his pulse rate was 144bpm, blood pressure 80/30mmHg, and GCS was 7/15. His right pupil was dilated but reactive. Back examination revealed severe contusion with friction burns and lacerations. A Focused Assessment Sonography for Trauma (FAST) was performed. No free intraperitoneal fluid was detected. CT scan of the brain has shown right temporo-parietal subdural hematoma and extensive hematoma in the deep subcutaneous soft tissues of the back. Decompressive cranicotomy and evacuation of the subdural hematoma was performed. On the 4th postoperative day, three liters of dark brown altered blood was drained from the subcutaneous plane. The patient developed severe hypovolemic shock and our aim was to identify and control the source of bleeding during the resuscitation. The source of bleeding was not obvious. Severe shearing force in blunt trauma causes separation between the loose subcutaneous tissues and the underlying relatively immobile deep fascia. This is known as post-traumatic closed degloving injury. To...Continue Reading

References

Jul 1, 1997·Journal of the American College of Surgeons·A BlumenfeldJ Shemer
Sep 21, 2007·Injury·John D HindsCraig G Morris
Apr 16, 2008·The American Journal of Emergency Medicine·Bruce M LoRebecca M Lipscomb
Jul 12, 2011·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·A PenaudG Zakine
Aug 13, 2011·Emergency Radiology·Anisha A SawkarSiddharth P Jadhav
Dec 30, 2011·Injury·Abhishek BansalAshwani Kumar Singh
Jan 25, 2014·The Journal of Trauma and Acute Care Surgery·Terry P NickersonHenry J Schiller
Mar 4, 2014·The Journal of Orthopaedic and Sports Physical Therapy·Michael GarrisonMichael R Johnson
Mar 19, 2014·Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES·Krishna Mohan GummallaRupak Dutta
May 7, 2014·Case Reports in Orthopedics·Shunsuke TakaharaMasahiro Kurosaka
Sep 30, 2014·Canadian Journal of Surgery. Journal Canadien De Chirurgie·Biao ZhongCong-feng Luo

❮ Previous
Next ❯

Citations

May 11, 2017·Revista do Colégio Brasileiro de Cirurgiões·Douglas Neumar MenonMarcio Eduardo Barros
Nov 26, 2019·Clinical Practice and Cases in Emergency Medicine·Lieke ClaassenErik Robert de Loos
Jan 6, 2021·International Journal of Surgery Case Reports·Mohamed Aziz DaghmouriLotfi Rebai
May 18, 2021·Trauma Case Reports·Ashraf F HefnyHisham Hurreiz

❮ Previous
Next ❯

Methods Mentioned

BETA
X-ray

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Trauma Monthly
Gholamreza FaridaalaeeTannaz Sattarzadeh Ghadim
Nō to shinkei = Brain and nerve
J Kawabuchi
The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyōbu Geka Gakkai Zasshi
Y HattoriS Sugimura
© 2021 Meta ULC. All rights reserved