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    Surgery Department: Emergency Case Reports

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    Mohamad Zulfikar
    This emergency case report summarizes the treatment of two patients admitted to the emergency room. The first patient, a 55-year-old male, suffered a moderate head injury from a motorcycle accident and was found to have a fractured and depressed frontal bone and intracranial hemorrhage. He underwent an emergency trepanation procedure to evacuate the hematoma and repair the fracture. The second patient, a male, suffered a lacerated wound to the left parietal region and was discharged after the wound was stitched. Both patients were expected to have a good prognosis.

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    Surgery Department: Emergency Case Reports

    Uploaded by

    Mohamad Zulfikar
    14 views17 pages
    This emergency case report summarizes the treatment of two patients admitted to the emergency room. The first patient, a 55-year-old male, suffered a moderate head injury from a motorcycle accident and was found to have a fractured and depressed frontal bone and intracranial hemorrhage. He underwent an emergency trepanation procedure to evacuate the hematoma and repair the fracture. The second patient, a male, suffered a lacerated wound to the left parietal region and was discharged after the wound was stitched. Both patients were expected to have a good prognosis.

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    ICH-Baso Hamka.pptx

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    This emergency case report summarizes the treatment of two patients admitted to the emergency room. The first patient, a 55-year-old male, suffered a moderate head injury from a motorcycle accident and was found to have a fractured and depressed frontal bone and intracranial hemorrhage. He underwent an emergency trepanation procedure to evacuate the hematoma and repair the fracture. The second patient, a male, suffered a lacerated wound to the left parietal region and was discharged after the wound was stitched. Both patients were expected to have a good prognosis.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    14 views17 pages

    Surgery Department: Emergency Case Reports

    Uploaded by

    Mohamad Zulfikar
    This emergency case report summarizes the treatment of two patients admitted to the emergency room. The first patient, a 55-year-old male, suffered a moderate head injury from a motorcycle accident and was found to have a fractured and depressed frontal bone and intracranial hemorrhage. He underwent an emergency trepanation procedure to evacuate the hematoma and repair the fracture. The second patient, a male, suffered a lacerated wound to the left parietal region and was discharged after the wound was stitched. Both patients were expected to have a good prognosis.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 17

    EMERGENCY CASE REPORTS

    Tuesday, January 4 th , 2011


    SURGERY DEPARTMENT
    RS. Wahidin Sudirohusodo

    EMERGENCY ROOM
    WAHIDIN SUDIROHUSODO
    GENERAL HOSPITAL
    MAKASSAR
    No. 1
    Name : Mr. ABD. Sex : Male
    RAHMAN
    No.
    Age : 55 years old Reg : 473079
    Chief complaint : Decreased of consciousness
    History taking : Suffered since 10 hours before admitted to the hospital
    due to traffic accident. There was history of vomiting and
    unconcius.
    Mechanism of : He was riding motorcycle with high speed, suddenly felt
    injury down, and his head bump to the asphalt. Next
    mechanism was unclear
    Injury sustain : Head
    Symptom & sign : Pain
    Examination : Physical examination, laboratory examination, CT Scan
    PHYSICAL EXAMINATION
    Primary Survey
    A: Clear

    B: RR : 24x/minutes, spontaneous, symmetric,


    Broncovesicular type

    C: BP : 120/90 mmHg, HR :76 x/minute, regular, adequate

    D: GCS 15 (E4M6V5), pupil isokor 2,5 mm / 2,5 mm , LR


    +/+
    E: T (ax) : 36,8
    Secondary Survey
    Right Orbital Region:
    I : Seen hematoma , stitch wound size 4 x 0,5 cm ,
    active bleeding (-)
    P : Tenderness difficult to evaluated, crepitating (-)
    Laboratory Result
    WBC : 32,9 x 103 / L

    RBC : 4,13 x 106 / L

    HGB : 11,7 g/dL

    HCT : 37,5%

    PLT : 314x103/ L

    CT / BT : 700 /3 00

    Blood Sugar : 106 mg/dl

    Ureum : 21 mg/dl

    Creatinin : 0,8 mg/dl

    GOT / GPT : 35/34 /L


    Cervical x ray
    Chest X - Ray
    Head CT- Scan
    WORKING DIAGNOSIS : Moderate head injury GCS 12 (E3M5V4)
    Fracture depressed frontal bone
    ICH at right frontobasal

    MANAGEMENT : O2
    IVFD
    Medicaments
    Report to senior neurosurgeon
    advice : Immediate trepanation

    PROGNOSIS : Good

    FOLLOW UP : Vital sign dan GCS


    Operating Procedure
    1. Patient laid supine under GA
    2. Asepsis and draping procedure
    3. Perform bicoronal incision, deepend while
    controlled bleeding.perform dura fascia flap seen
    depressed fracture at frontal bone.
    4. Perform 1 burr hole, continue craniectomy with
    craniotom
    5. Seen minimal EDH, evacuated hematom,
    stitching brain dura and controlled bleeding
    6. Place 1 suction drain
    7. Stitch wound layer by layer
    8. Operation finished
    WORKING DIAGNOSIS : Mild head injury GCS 15 (E4M6V5)
    Lacerated wound at left parietal region

    MANAGEMENT : Wound toilet


    Stitch wound patient discharge

    PROGNOSIS : Good

    FOLLOW UP :
    Vital sign and wound healing

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