Carotid artery injuries are rare with an incidence of 1%–2.6% in trauma patients. They are associated with high morbi-mortality rates, with mortality ranging from 19% to 43%. The diagnosis relies mainly on computed tomography angiography in the emergency setting; however, it is fundamental to be able to suspect carotid artery injuries on non-contrast computed tomography, as the latter is the routine imaging tool for trauma patients. We report the case of a young male, victim of a blunt high velocity motor-vehicle trauma. He was unconscious, with abundant epistaxis and hypovolemic shock. A fracture of the left carotid canal on non-contrast computed tomography was seen, raising concern for an arterial injury. A computed tomography angiography was performed subsequently revealing a transection of the internal carotid artery. This type of injury is highly lethal, and its management relies on urgent surgical intervention, and endovascular treatment, with the purpose of controlling the hemorrhage.
Introduction: Feeding jejunostomy is a rather safe procedure. Major complications are rare, but can be serious, nevertheless.
Case Report: We report a case of a 57-year-old male, diagnosed with epidermoid carcinoma of the larynx. The patient received 3 cures of induction chemotherapy before being lost to follow-up. One year later, the patient presented with significant dysphagia and benefited from a feeding jejunostomy utilizing the Witzel technique. Postoperative course was marked by abdominal tenderness, and hemodynamic and respiratory impairment. Lab tests showed a continuous elevation of markers of infection. Computed tomography (CT) scan revealed an extradigestive distal end of the jejunostomy tube, associated with a voluminous pneumoperitoneum, predominant around the tube end, keeping with a small bowel perforation. The evolution was marked by respiratory fatigue, and hemodynamic instability. The patient, unfortunately died subsequently, despite maximal supportive measures.
Conclusion: Computed tomography (CT) scan is a helpful tool for the diagnosis of feeding jejunostomy’s major complications besides physical examination and biology. Limiting the indications of this surgical procedure and being attentive to surgical details may help reduce the risk of complications.
Tracheobronchial injuries following blunt chest trauma are rare and can be lethal. CT scan can help to diagnose it when a defect to the tracheobronchial wall is visible or to suspect it in front of indirect signs. K E Y W O R D S bronchial tear, chest blunt trauma, chest CT F I G U R E 1 Contrast-enhanced coronal reformat CT image in the lung window showing a left main bronchus tear (Arrow)
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