Wound Complications

Question 1

List causes of arterial air embolism

Answer 1

1. Penetrating chest trauma
2. Blunt chest trauma: mechanism involves formation of a bronchopulmonary venous fistula
3. Migration from the venous circulation via right-to-left shunt

Question 2

List causes of venous air embolsim

Answer 2

1. Blunt head trauma resulting in open displaced cranial fractures
2. Penetrating an dblunt chest trauma
3. Cut-throat
4. Pushing air under pressure such as in tubal insfflation or criminal abortion

Question 3

Mention sie and timing of each type of GIT ulceration

Answer 3

1. Stress ulcer: fundus and body appears after 24 hrs
2. Cushing ulcer: stomach and duodenum, mostly seen in third stage of cushing triad
3. Curling’s ulcer: (early>same as stress ulcer), (late>appears after 2 weeks in duodenum and may show signs of chronicity

Question 4

Describe timing of DIC

Answer 4

It could be expected from the early ohase of trauma
1) DIC (fibrinolytic phase) begins at the acute phase of trauma and contributes to massive bleeding and death.
2) during the late period of trauma, the activation of coagulation lead to multiorgan dysfunction and consequent poor outcome within the first 24to 48 hours