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The abdominal wall split transversely, extruding undamaged bowel. After resuscitation, according to the ATLS protocol, the client underwent eight laparotomies for damage control. After 45 times when you look at the medical Intensive Care Unit, then 11 times when you look at the surgical ward, he had been released in a reasonable problem. Eight months later on, he was admitted electively for ileostomy reversal, that was uneventful. Conclusion Patients with a high stress mechanisms have actually large mortality and morbidity rate. Blunt injury with eviscerated stomach contents calls for prompt, expeditious, and timely intervention, specially at the preliminary operative intervention with damage control procedures, both prompt management and structured method, were tailored based in the magnitude associated with injury. A multidisciplinary approach is necessary through the amount of treatment until data recovery and rehabilitation.Introduction Blue Rubber Bleb Nevus Syndrome (BRBNS) also known as Bean's Syndrome is an atypical types of vascular malformation. To date, around 200 instances have already been reported world-wide. In view of their reasonable occurrence price, physicians might misdiagnose and under treat. The main element popular features of this syndrome are characterized by several cutaneous, smooth muscle and gastrointestinal system venous malformations. Presentation of instance We report initial instance of Blue Rubber Bleb Nevus Syndrome in Malaysia, a 23 yrs . old Malay woman who is affected with several cutaneous venous malformation and intestinal bleeding episodes. Discussion The typical morbidity for this syndrome is symptomatic anemia as a result of additional iron defecit as a result of the intestinal venous malformation bleeding. In managing the gastrointestinal bleeding, it mainly is based on the seriousness of intestinal bleeding, some may resolve spontaneously, while the other individuals are needing bloodstream transfusion, and some may necessitate GIT resections. As for cutaneous lesions, normally its innocuous with regards to the area and dimensions. Large or challenging cutaneous venous malformation might benefit from sclerotherapy or excision. Conclusion Multidisciplinary approach is a must in managing BRBNS case due to its complexity additionally the spectral range of multiple organ participation to ensure the best result to your patient.Introduction Global death as a result of road nos signals traffic accidents (RTA) has paid off notably since required implementation of seatbelts. Whilst seatbelt related injury, or "seatbelt problem," is a recognised event, unrestrained passengers have actually dramatically worse survival outcomes. Poor positioning of seatbelts, as is talked about into the after instance, may cause extensive damage. Presentation of instance Our client is a 35-year-old feminine who had been a restrained forward seat passenger in a car vs. tree collision at 80 km/h. Her seat belt was worn with the shoulder strap under her remaining axilla. She sustained multiple injuries including full transection for the gastroduodenal junction. Along with this she had splenic, liver, transverse colonic, left lower rib and humeral injury. She underwent damage control laparotomy with splenectomy; re-look with gastrojejunostomy and transverse colonic resection with defunctioning ileostomy. She made a good data recovery and was released after a 4 few days entry. Discussion Improperly used seatbelts redistribute decelerative forces to delicate areas. A multidisciplinary strategy is needed to efficiently manage complex multi-system traumatization. In trauma the simplest reconstructive actions could possibly be the most effective and minimise chance of further complications for the patient. Conclusion incorrectly worn seatbelts pose a substantial risk to clients. A traumatic complete gastroduodenal transection is effectively reconstructed with gastrojejunostomy anastomosis.Introduction Current treatment in managing client with osteosarcoma is mixture of chemotherapy and surgery, either limb-sparing or limb-ablation surgery. One challenge in limb-sparing technique in children is how to deal with the rest of the growth of the bone tissue. We created a limb-sparing repair technique which can be fitted in various types of hospital and now have good practical outcome. Case presentation We reported an incident of 13-years-old female with left leg pain since 8 period prior hospital admission with earlier therapy to a bone setter and open biopsy at previous medical center. Histopathological results demonstrated osteosarcoma. The patient had a neoadjuvant chemotherapy and implemented with limb-sparing surgery. We performed large excision of proximal tibia and reconstruction utilizing a bone on polyethylene hemiarthroplasty system of this knee-joint. Individual then continued on adjuvant chemotherapy. In the future, regional recurrence occurred and now we performed excision once more. Within a year, the individual could go full weight bearing, perform daily activities with no restriction and no discomfort, and she had MSTS score of 21. Discussion Limb-sparing surgery remains a challenging procedure in skeletally immature patients. This bone on polyethylene method is practical because of high adaptability in paediatric customers so that you can reduce the quantity of surgeries until the final goal of limb equalization. Conclusion Bone on polyethylene hemiarthroplasty system makes it possible for good and trustworthy practical result while keeping the knee-joint for everyday task.