Progressive Ulnar Neuropathy Following a Presumed Catfish Sting.

IF 1.4 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Wilderness & Environmental Medicine Pub Date : 2024-12-01 Epub Date: 2024-09-02 DOI:10.1177/10806032241272131
Taylor Checkley, Madeline Cole, Mohammadali M Shoja, Gary Schwartz
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引用次数: 0

Abstract

Catfish are a highly diverse group of fish comprising more than 3500 species found in both freshwater and marine ecosystems. Upon handling, they can inflict a sting, with certain species capable of inducing significant pain and injury to the affected extremity. The prevalence of aquatic activities, such as fishing by line or manual capture ("noodling"), increases the likelihood of catfish stings, making prompt identification and treatment an important aspect of managing such encounters. A case of a presumed catfish spine injury during noodling in Tallahassee, Florida, is presented. The pectoral fin penetrated the volar aspect of the patient's right hand resulting in immediate pain and numbness. Over the course of 2 weeks, the patient developed distal ulnar neuropathy with conduction block at the wrist level. Surgical exploration revealed the ulnar nerve to be grossly intact, but the area surrounding the terminal division point of the ulnar nerve in the hand displayed infiltration by fibrous tissue that entrapped the nerve and its branches. Following surgical release of the ulnar nerve and its terminal branches from the fibrous tissue, complete resolution of distal ulnar neuropathy was achieved. In this patient's case, the absence of foreign bodies and the lack of visible nerve damage suggest that the injury to the patient's hand was largely attributable to toxin-mediated proinflammatory response and fibrosis.

假定被鲶鱼刺伤后出现渐进性尺神经病。
鲶鱼是一种种类繁多的鱼类,在淡水和海洋生态系统中有 3500 多个品种。在处理鲶鱼时,鲶鱼可能会刺伤人,某些种类的鲶鱼还可能会给受影响的肢体造成明显的疼痛和伤害。水上活动(如用鱼线捕鱼或人工捕捉("捞面条"))的盛行增加了鲶鱼蜇伤的可能性,因此及时识别和治疗是处理此类事件的一个重要方面。本报告介绍了佛罗里达州塔拉哈西市一起鲶鱼脊柱受伤的假定案例。胸鳍穿透了患者右手的外侧,立即导致疼痛和麻木。两周后,患者出现尺骨远端神经病变,手腕处出现传导阻滞。手术探查显示尺神经大体完好,但手部尺神经末端分叉点周围区域显示有纤维组织浸润,卡住了神经及其分支。通过手术将尺骨神经及其末端分支从纤维组织中释放出来后,尺骨远端神经病变得以完全治愈。在这名患者的病例中,没有异物,也没有明显的神经损伤,这表明患者手部的损伤主要归因于毒素介导的促炎反应和纤维化。
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来源期刊
Wilderness & Environmental Medicine
Wilderness & Environmental Medicine 医学-公共卫生、环境卫生与职业卫生
CiteScore
2.10
自引率
7.10%
发文量
96
审稿时长
>12 weeks
期刊介绍: Wilderness & Environmental Medicine, the official journal of the Wilderness Medical Society, is the leading journal for physicians practicing medicine in austere environments. This quarterly journal features articles on all aspects of wilderness medicine, including high altitude and climbing, cold- and heat-related phenomena, natural environmental disasters, immersion and near-drowning, diving, and barotrauma, hazardous plants/animals/insects/marine animals, animal attacks, search and rescue, ethical and legal issues, aeromedial transport, survival physiology, medicine in remote environments, travel medicine, operational medicine, and wilderness trauma management. It presents original research and clinical reports from scientists and practitioners around the globe. WEM invites submissions from authors who want to take advantage of our established publication''s unique scope, wide readership, and international recognition in the field of wilderness medicine. Its readership is a diverse group of medical and outdoor professionals who choose WEM as their primary wilderness medical resource.
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