Introduction
Accidents involving chainsaws are not uncommon in trauma care and may present as penetrating injuries with retention of a foreign object in the patient's chest. The current literature, however, does not present a consensus on the best way to approach these cases.
Presentation of case
Male patient, 46-year-old man, born in Amazonas countryside, brought to the city of Manaus with a penetrating injury resulting from an accident with a chainsaw and retaining a 2cm sawtooth in his chest, six days after the event. After laboratory and imaging tests, as well as pre-operative preparation, an open thoracotomy was realized, the object was removed, and the patient was placed under a thoracostomy tube.
Discussion
The diagnosis of chainsaw incidents is generally described in the literature as post-mortem, mainly due to the inappropriate use of the equipment. Surgical removal of a foreign body is indicated in most cases, except when it is peripheral or when there is some impossibility. Early surgical treatment benefits the patient, with lower mortality and morbidity.
Conclusion
In view of the absence of consensus and guidelines to the approach of thoracic injury with foreign body retention, it is up to the surgeon to evaluate the best conduct in each case and according to the available resources.
Objetivo: Analisar a Doença hemolítica do recém-nascido (DHRN) e suas repercussões na saúde materno-infantil. Revisão bibliográfica: A DHRN é uma condição na qual a gestante, já sensibilizada com aloantígenos, produz anticorpos contra as hemácias do feto, ocorrendo nos casos de incompatibilidade pelo sistema ABO ou Rh em sua maioria. Os anticorpos produzidos pela mãe são majoritariamente do tipo anti-D, sendo que apenas a classe IgG atravessa a barreira hematoplacentária e causa a doença. Para diagnóstico, deve ser feito estudo da tipagem sanguínea materna e paterna, ultrassom obstétrico e dopplervelocimetria fetal. Quando a doença é de caráter leve-moderado, não há grandes repercussões e a terapêutica pode ser realizada com um bom prognóstico; entretanto quando um estado grave se instala, com desenvolvimento de Kernicterus e hidropisia, o tratamento se torna mais complexo e custoso. Considerações finais: Por se tratar de uma doença evitável na maioria dos casos por meio da profilaxia pela imunoglobulina anti-D é recomendado sua utilização de forma adequada a fim de reduzir o aparecimento da doença e suas complicações.
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