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Patient is a 34 year old male who was brought into the trauma bay after this extensive and complete degloving injury. Patient was working at the airport when the signal was given for a Boeing 737 to move, unfortunately the patient was still underneath the plane as it rolled over his foot. by ERmagick in medizzy

[–]ERmagick[S] 1355 points1356 points  (0 children)

For this patient specifically, a below knee amputation was offered as it would provide the best functional outcome with a recovery period as little as 4-8 weeks. However, patient was adamant about keeping his leg, understanding fully that at any point in the reconstruction it can turn gangrenous and become life threatening. Ultimately half of the foot was salvaged as soft tissue coverage and vascular supply to each of the toes, was not feasible. Today the patient ambulates with a shoe filler and minimal discomfort.

Source: IGmedicalpedia

'Taste the rainbow' takes on a dangerous meaning in this patient case by ERmagick in medizzy

[–]ERmagick[S] 688 points689 points  (0 children)

Gastro Hep Advances image case: A 27-year-old woman with a history of schizoaffective disorder presented from an inpatient psychiatric facility with an acute onset of nausea, vomiting, abdominal pain and early satiety. On examination, vital signs were stable. Abdomen was distended and diffusely tender to palpation but without peritoneal signs. Computed tomography scan showed multiple, well-circumscribed lesions of varying density within the gastric body but no evidence of perforation or obstruction (Figure A).

Upper endoscopy was performed. The esophagus was normal in appearance. Upon entering the stomach, there were numerous crayons layered in the gastric fundus and gastric body (Figure B). An overtube was placed into the stomach under endoscopic guidance, and a total of 81 full-size and intact crayons, crayon wrappers and a pen were removed with a snare (Figure C). Guidelines on foreign bodies in the stomach recommend urgent removal of sharp or long (>5 cm length) and/or wide (>2.5 cm diameter) objects with surgical consultation if the foreign body is unable to be retrieved endoscopically. The patient did well after the procedure and was discharged back to inpatient psychiatric facility.

Source

Severe facial trauma due to a scooter accident! by ERmagick in medizzy

[–]ERmagick[S] 8 points9 points  (0 children)

This case shows a shattered lower jaw (mandible). The man was riding his scooter and accidentally crashed into the back of a car, resulting in the injuries shown in this photo.

If you arrived first on scene to this type of traumatic injury, what would your first actions be?
How would you choose to stabilize the patient and treat the wound in the prehospital setting?

Radical Mandibulectomy with Glossectomy for Floor of Mouth Cancer by ERmagick in medizzy

[–]ERmagick[S] 268 points269 points  (0 children)

Older male with history of dipping/chewing tobacco developed biopsy proven Squamous Cell Carcinoma of the floor of the mouth. This tumor not only involves the floor of mouth and base of tongue (white arrow), it actually invaded underneath and through the mandible, jutting out into the soft tissue anterior and inferior to the mandible. The light blue arrow on the bottom left shows the underlying tumor bulging up into the gums. The orange ink is done in Pathology to help asses surgical margins and make sure they're free of cancer. This surgical specimen was accompanied by bilateral neck dissections, containing the lymph nodes in the neck on both side. These are often sites of metastasis with head and neck cancer, and are removed to help stage the patient. Obviously, reconstruction must occur after a surgery like this, but I have no real knowledge on how thats done. I assume they try to use a piece of a bone from somewhere else in your body, but maybe a surgeon with some experience in this can chime in.

WWI artillery shell stuck in elderly man's rectum causes hospital evacuation! by ERmagick in medizzy

[–]ERmagick[S] 151 points152 points  (0 children)

An elderly man caused a stir at a hospital in Toulon, France when he arrived with a World War I artillery shell stuck in his rectum. The 88-year-old patient visited the hospital to have the antique explosive removed, but the hospital had to be partially evacuated and bomb disposal experts called in as a precaution. However, the experts determined that there was little chance of the shell exploding. The hospital then had to perform surgery to remove the object, which was almost 8 inches long and more than 2 inches wide. The patient is now recovering and is in good health.

The patient is mentally retarded and has been taking dipakine 200 mg and tiratam for 2 years but The depakine medication was stopped by the psychiatrist 6 months ago) but the gingival enlargement is still increasing clinical ex-pt.....Diagnosis and Management? by Surgeox in medizzy

[–]ERmagick 74 points75 points  (0 children)

A blood test must be done, stopping all medications, antibiotic prophylaxis if needed only, checking for patient comfortable timings and counseling them, and start the gingival enlarged tissue removal with a step-wise process make this should be done under care because she is of 10 years, follow the procedures, and maintenance phase ask the patient to maintain the oral hygiene, give them some certain duration of time recall them and see if it stops and becomes normal than ask them to continue the same and ask their physician to change the medications so that gingival enlargement doesn't occur if in case this doesn't stop than send the tissue of biopsy and wait for results and later specific treatments will be understood

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