Journal of Trauma and Injury

Case Report

Blunt Transection of the Entire Anterolateral Abdominal Wall Musculature Following Seatbelt-Related Injury: Hohyun Kim, Jae Hun Kim, Gil Hwan Kim, Hyun-Woo Sun, Chan Ik Park, Sung Jin Park, Chan Kyu Lee, Suk Kim; J Trauma Inj. 2020;33(2):128-133. Published online June 30, 2020; DOI: https://doi.org/10.20408/jti.2020.0006

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Abstract PDF: Traumatic abdominal wall hernias (TAWHs) are uncommon and the incidence of this, which is rarely encountered in clinical practice, has been estimated at 1%. Furthermore, blunt transection of the entire abdominal wall musculature caused by seatbelt is a very rare complication. We report a case of adult with a complete disruption of the entire anterolateral abdominal wall muscle following the seatbelt injury. A 32-year-old male was wearing a seat belt in a high speed motor vehicle collision. Abdominal computed tomography (CT) scan revealed the complete disruption of bilateral abdominal wall musculatures including TAWH without visceral injury. However, injuries of small bowel and sigmoid colon were observed in the intra-operative field. The patient underwent the repair by primary closure of the defect with absorbable monofilament sutures. This case suggests that especially in TAWH patients, even if a CT scan is normal, clinicians should keep the possibility of bowel injury in mind, and choose a treatment based on the clinical findings.; Summary

Original Article

Clinical Outcomes of Diffuse Axonal Injury According to Radiological Grade: Hak-Jae Lee, Hyun-Woo Sun, Jae-Seok Lee, Nak-Joon Choi, Yoon-Joong Jung, Suk-Kyung Hong; J Trauma Inj. 2018;31(2):51-57. Published online August 31, 2018; DOI: https://doi.org/10.20408/jti.2018.31.2.51

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Abstract PDF

Purpose

Patients with diffuse axonal injury experience various disabilities and have a high cost of treatment. Recent researches have revealed the underlying mechanism and pathogenesis of diffuse axonal injury. This study aimed to investigate the correlation between the radiological grading of diffuse axonal injury and the clinical outcomes of patients.

Methods

From January 2011 to December 2016, among 294 patients with traumatic brain injury, 44 patients underwent magnetic resonance imaging (MRI). A total of 18 patients were enrolled in this study except for other cerebral injuries, such as cerebral hemorrhage or hypoxic brain damage. Demographic data, clinical data, and radiological findings were retrospectively reviewed. The grading of diffuse axonal injury was analyzed based on patient’s MRI findings.

Results

For the most severe diffuse axonal injury patients, prolonged intensive care unit (ICU) stay (p=0.035), hospital stay (p=0.012), and prolonged mechanical ventilation (p=0.030) were observed. However, there was no significant difference in healthcare-associated infection rates between MRI grading (p=0.123). Massive transfusion, initial hemoglobin and lactate levels, and MRI gradings were found to be highly significant in predicting the duration of unconsciousness.

Conclusions

This study showed that patients with high grade diffuse axonal injury have prolonged ICU stays and significantly longer hospital stays. Deteriorated mental patients with high energy injuries should be evaluated to identify diffuse axonal injuries by using an appropriate imaging tool, such as MRI. It will be important to predict the duration of consciousness recovery using MRI scans.

Summary

Citations

Citations to this article as recorded by

Prediction for the prognosis of diffuse axonal injury using automated pupillometry
Makoto Murase, Shinichi Yasuda, Makoto Sawano
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Head CT for the intensivist: 10 tips and pearls
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Minerva Anestesiologica.2022;[Epub] CrossRef
Evaluation of Laboratory Variables Related to Diffuse Axonal Injury: A Cross-sectional Study
Masoud Hatefi, Khalil Komlakh
Archives of Neuroscience.2022;[Epub] CrossRef
Clinical outcomes of diffuse axonal injury after traumatic brain injury according to magnetic resonance grading
Insu Lee, Kawngwoo Park, Tae Seok Jeong, Woo-Seok Kim, Woo Kyung Kim, Do Yeon Rhee, Cheol Wan Park
Journal of Korean Society of Geriatric Neurosurger.2021; 16(2): 71. CrossRef
Use of Magnetic Resonance Imaging in Acute Traumatic Brain Injury Patients is Associated with Lower Inpatient Mortality
Hwan Lee, Yifeng Yang, Jiehui Xu, Jeffrey B. Ware, Baogiong Liu
Journal of Clinical Imaging Science.2021; 11: 53. CrossRef

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