%0 Journal Article
%T Surgical emergencies confounded by H1N1 influenza infection - a plea for concern
%A Benjamin Person
%A Hany Bahouth
%A Eran Brauner
%A Offir Ben-Ishay
%A Amitai Bickel
%A Yoram S Kluger
%J World Journal of Emergency Surgery
%D 2010
%I BioMed Central
%R 10.1186/1749-7922-5-6
%X Recently, we treated 3 patients with various surgical emergencies who were also diagnosed with active H1N1 influenza. The purpose of this report is to bring the issue of H1N1 flu in association with surgical emergencies to the forefront of the literature, and suggest that surgical diseases might be significantly accentuated in patients with H1N1 influenza.Since the outbreak of the H1N1 influenza pandemic in April 2009, an enormous body of literature presented various aspects of this new disease. Most of the reports describe epidemiological characteristics [1,2] or the medical course and outcomes of patients with H1N1 [3-5], and are therefore presented mostly in the internal medicine or critical care medicine literature [6-9].Recently, our acute care surgery service was confronted with 3 patients who presented with relatively common surgical emergencies; however, due to concurrent H1N1 infection, their hospital course was unexpectedly and dramatically extraordinary.A healthy 19-year-old man fell from a 3-meter-long ladder and hit his head. At the scene he was comatose with a Glasgow Coma Score of 4; a right dilated and unresponsive pupil and no other obvious injuries were identified. He was intubated, ventilated and transferred to our trauma center. His family members reported that he complained of having a sore throat in the preceding 2 days. On admission, the initial significant physical findings were a fever of 39.5ˇăC, a heart rate of 150 beats/min and normal blood pressure. A large right fronto-parietal subcutaneous hematoma and a dilated right pupil were revealed. The chest X-ray was consistent with bilateral infiltrates that were presumed to be lung contusions or the result of aspiration. An abdominal ultrasound did not show intra-peritoneal, pelvic or pericardial fluid. A CT scan of the brain revealed a large fronto-parietal epidural hematoma on the right with a significant mass effect, and multiple fractures of the frontal and temporal bones. A CT scan of the
%U http://www.wjes.org/content/5/1/6