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Article
Penetrating Injuries of the Neck

Authors: Musaed L. H. Albadri --- Uday A. Albeiruty --- Ahmed Abass Mossa
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2009 Volume: 8 Issue: 3 Pages: 196-203
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

BACKGROUND:Penetrating injuries of the neck are potentially dangerous, causing high rates of morbidity and mortality due to their association with sever bleeding and serious damage to the vital structures in the cervical region.OBJECTIVE:To know the incidence and distribution of these injuries on the anatomical zones of the neck and the damage of the vital structures in the cervical region and their early surgical management.METHODS:A prospective study on 52 patients of both civilian and military personnel with penetrating neck injuries attended the casualty department at Alyarmouk hospital over a period of 7 months from June-December 2006.RESULTS:Fifty patients (96.15%) were males. Twenty four patients (46.15%) were in their third decade. Twenty six patients (50%) were injured by shrapnel of explosives, 23 patients (44.21%) by bullets & 3 patients (5.77%) by unknown objects. Thirty six patients (69.23%) were injured at zone 2, 11 patients (21.15%) at zone 3 & 5 patients (9.62%) at zone 1. Twenty nine patients (55.77%) had laryngeal & tracheal injuries. Thirteen patients (25%) had pharyngeal & esophageal injuries. Four patients (7.7%) had recurrent laryngeal nerve injury. Nine patients (17.3%) had vascular injuries 6 arterial & 3 venous. One patient had vertebral & spinal cord injury. Forty one patients (78.86%) had tracheostomy operations, & 13, (25%) had neck exploration.Six patients (11.54%) treated conservatively. Nine patients (17.3%) have died.CONCLUSION:Male patients at their middle age were the predominant victims either by shrapnel or by bullets. Zone 2 was most commonly affected followed by zone 3 & zone 1. Laryngo – tracheal, pharyngo – esophageal & vascular structures were mostly involved. Tracheostomy & neck exploration were the main urgent operations performed for them. The high mortality reflected the serious nature of these injuries.


Article
The Outcome of Retained Metallic Foreign Bodies in Upper and Lower Limbs…………...

Author: Ali Khairi Toman
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2009 Volume: 2 no.8, 9 Issue: 5 Pages: 692-696
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Retained metallic fragments represent a common problem thatcan be encountered in surgical practice.They could be bullets, part of bullets or other fragments and shells frombombs or mines or in rare occasion, different foreign particles from the environment.They are always the cause of patients complain to whom they refer their pain ordisabilities and sometime they insist for their removal.Operations for removal of deep retained foreign bodies are not beneficial, take longtime and consume a lot of materials and sometime could be very risky, cause moredamage and in some cases, ended without finding the foreign body.There are only few indications for removal of retained metallic fragments.Objectives: We want to assess the problem of retained metallic foreign bodies andfind the indications of their removal.Patients and Methods: This is a prospective study of 300 patients with retainedmetallic foreign bodies presented to the out-patient department of Alhindiya generalhospital between July 2006 and July 2008 with different complains.Results: Three hundred patients were included in this study, 264 patients(82%) weremales and 36 patients (18%)were females, 270 patients about (90%) presented withinthe first week after injury, 243 patients(81%) have foreign bodies in the upper andlower limbs, 45 patients(15%) in the trunk and 12 patients(4%) in the head & neck.Conclusion: Palpable foreign body can be removed safely and successfully in most ofthe cases while deep foreign body should not be removed unless there are indications.

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