blunt force trauma

钝器外伤
  • 文章类型: Journal Article
    颈部钝性损伤导致的甲状腺外伤性出血是非常罕见的事件。特定的颈部位置会使甲状腺遭受创伤,尤其是在机动车碰撞中,falls,直接打击,或体育活动。先前存在的疾病,如甲状腺肿,腺瘤,囊肿会增加出血的风险,减少腺体破裂所需的力量,使甲状腺更容易受伤。作者报告了一名53岁的男子在维护液化石油气(LPG)动力汽车时卷入火灾的案例。随后,他向急诊科就诊,右前颈部疼痛性肿胀,肿块明显。CT扫描显示右侧甲状腺出血性囊肿。工人报告说,他跳进汽车后备箱灭火,并用自己的身体盖住煤气罐喷嘴,以防止助燃剂扩散。在这种情况下,医学-法律评估有助于区分伤害的自然原因和创伤原因。医学法律评估是了解与工作相关的事件所涉及的动态的关键,以确定工人或雇主的任何法律责任。
    Traumatic hemorrhage of the thyroid gland resulting from blunt injury to the neck is a very rare event. Particular neck positions can expose the thyroid to trauma, especially in motor vehicle collisions, falls, direct blows, or sport activities. Preexisting conditions such as goiters, adenomas, and cysts can increase the risk of bleeding, reducing the force required to rupture the gland and make the thyroid more prone to injury. The authors report the case of a 53-year-old man who was involved in a fire while working on maintenance of a liquid petroleum gas (LPG)-powered car. He subsequently presented to the emergency department with painful swelling of his right anterior neck with a palpable mass. CT scan showed a right thyroid hemorrhagic cyst. The worker reported that he had jumped into the car trunk to extinguish the fire and covered the gas tank nozzle with his own body to prevent dispersal of the accelerant. In this case, the medico-legal evaluation was useful to delineate between natural and traumatic causes of the injury. Medico-legal assessment is key in understanding the dynamics involved in work-related events to identify any legal responsibilities of the worker or the employer.
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  • 文章类型: Journal Article
    3D打印已迅速发展并应用于法医学,因为它用于为法院创建演示。关于这一特定主题的许多文献都集中在学术界使用3D打印模型。对陪审团的潜在影响,以及它作为一个长期的文档过程的使用,但几乎没有真正的法医案例。本文介绍了3D打印在法医实践中的发展,以及3D打印目前如何在英格兰和威尔士的刑事司法系统中使用。从英国的多个警察部队和法医从业人员那里收集了一系列病例报告,以确定如何使用3D打印。这些讨论确定了谁要求3D打印展品,正在使用哪种类型的技术,正在印刷什么类型的展品,以及在刑事案件中使用3D打印材料的反馈。因此,这项研究展示了3D打印在英格兰和威尔士的当前使用,讨论已知结合3D打印的相关案例。同样,这项工作探索了法医从业人员遇到的局限性,并确定了一系列在未来调查中应考虑的研究问题。
    3D printing has rapidly developed and been applied in forensic science due to its use in creating demonstrations for courts of law. Much of the literature on this specific topic has focused on the use of 3D printed models in academia, the potential influence on a jury, and its use as a long-term documentation process, but with few actual forensic case examples. This paper offers an insight into the development of 3D printing in forensic practice and how 3D printing is currently being used in the criminal justice system in England and Wales.A series of case reports were gathered from multiple police forces and forensic practitioners in the UK to identify how 3D printing was being used. These discussions established who was requesting 3D printed exhibits, what type of technologies were being utilised, what type of exhibits were being printed, and resulting feedback for the use of 3D printed material within a criminal case. As a result, this research demonstrates the current use of 3D printing in England and Wales, discussing the associated cases that have been known to incorporate 3D prints. Likewise, this work explores the limitations that have been encountered by forensic practitioners and identifies a series of research questions that should be considered in future investigations.
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  • 文章类型: Case Reports
    乳糜胸是胸部淋巴损伤的潜在破坏性并发症。迄今为止,没有任何建议为及时确定治疗提供决策支持.我们介绍了一名53岁的男性,该男性参与了一次机动车碰撞,其中有9个左肋骨骨折,连ail段。他接受了胸管和无脂肪饮食的非手术治疗。进行了病例报告审查,并制定了成人患者钝性乳糜胸治疗指南。在低输出乳糜胸,有效的初始治疗始于无脂肪饮食和胸管。我们建议将低输出泄漏定义为初始输出<500mL或<500mL/天,并且可以在近100%的患者中进行非手术管理。>1000mL初始输出的高输出损伤将需要手术干预,应考虑及时明确护理。
    Chylothorax is a potentially devastating complication of lymphatic trauma of the thorax. To date, no recommendations have provided decision making support for prompt definitive treatment. We present a 53 year old male involved in a motor vehicle collision sustaining 9 left rib fractures with flail segments. He was treated non-operatively with a chest tube and no fat diet. A Case report review was performed and a proposed guideline for managing blunt trauma chylothorax in adult patients was developed. In low-output chylothorax, effective initial treatment begins with a no fat diet and chest tube. We propose that a low output leak be defined as <500 mL of initial output or <500 mL/day and can be managed non-operatively in nearly 100% of patients. High output injuries of >1000 mL of initial output will require surgical intervention and should be considered for prompt definitive care.
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  • 文章类型: Case Reports
    Prevailing over in rotationally unstable pelvic fractures, acetabular fractures or hip dislocations, superior gluteal artery pseudo aneurysm imperceptibly could be found after blunt force trauma of the pelvic region. We present a case of superior gluteal artery pseudo aneurysm after blunt force trauma that became gradually symptomatic in two months following the prime malevolence. Non-resolving gluteal hematoma presented two months after the incident, disregarding standard treatment methods led the diagnosis to plausible entity of pseudo aneurysm. Standard protocol was followed. CT angiography was indicated and it confirmed the suspected diagnosis. Upon indication a treatment plan was established with correspondent angioembolization of the pathologic substrate. Pseudo aneurism of the superior gluteal artery should be considered as differential diagnosis for unexplained hematomas in the posterior pelvic region following a trauma regardless of its nature.
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  • 文章类型: Case Reports
    The term \'B.A.S.E jump\' refers to jumping from a building, antenna, span (i.e., bridge) or earth (i.e., cliff) structure, and parachuting to the ground. There are numerous hazards associated with B.A.S.E jumps which often result in injury and, occasionally, fatality. This case report details the skeletal trauma resulting from a fatal B.A.S.E jump in Australia. In this case, the jumper impacted the ground from a fall of 439m in a feet-first landing position, as a result of a partially deployed parachute, under extreme vertical deceleration. Skeletal trauma was analyzed using full-body post mortem computed tomography (PMCT) and contextual information related to the circumstances of the jump as reported by the Coroner. Trauma to 61 skeletal elements indicates the primary impact was to the feet (i.e., feet-first landing), followed by an anterior impact to the body (i.e., fall forwards). Details of the individual fracture morphologies indicate the various forces and biomechanics involved in this fall event. This case presents the types of fractures that result from a B.A.S.E jump, and highlights the value of using PMCT and coronial data as tools to augment skeletal trauma interpretations.
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