Sunder Goyal

Abstract

Neck trauma due to compressing injury (accompanied by surgical emphysema and pneumomediastinum) can be critical. It may develop in up to 10% of patients and may be a significant cause of morbidity and mortality due to the associated damage to the aerodigestive tract. Depending on the extent and severity of aerodigestive tract injury, management varies between conservative to surgical intervention. We present a case of blunt compressing neck trauma accompanied by subcutaneous emphysema secondary to compression of the neck by a cloth around the neck pulled by entangling in the shaft of a running electrical motor. It resulted in a leak in the oropharyngeal region which caused surgical emphysema in the cervicofacial region and  pneumomediastinum. Its radiologic appearance, clinical presentation, and initial management options in the emergency department (ED) are presented here. Keywords: Blunt neck trauma, Pneumomediastinum, Subcutaneous emphysema electrical motor shaft.

View Article

Abstract

Aim: Cystic lesions in Spleen are common, but a hydatid cyst is uncommon. No doubt, the occurrence of hydatid disease has decreased due to handwashing after contact with canine species, vigorous washing & cooking of vegetables before eating, and stoppage feeding the slaughtered animal’s guts to dogs. Its incidence at unusual sites is about 8-10%. These uncommon sites are Spleen, psoas muscle, pelvic cavity, peritoneum, mesentery, brain, kidneys, bones, muscles and soft tissues. Primary extrahepatic hydatid cysts are uncommon, and primary splenic hydatid cyst (SHC) is even more so. Hydatid disease of the Spleen is known since 1790 as endorsed by Berlot and is caused by Echinococcus granulosus. Materials and Methods: Discussed below is a literature review focusing on the epidemiology, pathology, clinical presentation, investigations, treatment and follow up modalities of splenic-hydatidosis. Results: Our literature review examines dissimilar articles published on this topic and sum up the data obtained. Conclusion: The incidence of splenic involvement by hydatid cysts in relation to the rest of the abdominal viscera is very low and is about 0.5 to 4% of all cases of hydatidosis. Man is an accidental intermediate and end-stage host in its life cycle. Splenectomy (open and laparoscopic) was the gold standard treatment for splenic hydatidosis as medical therapy seems ineffective. However, the last two decades have shown a leaning towards splenic conservative surgery in suitable cases to reduce opportunistic post-splenectomy infection (OPSI). Keywords: Hydatid cyst, Spleen, Echinococcus granulosus, Splenic conservative surgery.

View Article