• Title/Summary/Keyword: Chest blunt trauma

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Left Atrial Rupture with Stable Vital Signs - A case report - (정상인 활력증후를 보인 좌심방 파열 - 1예 보고 -)

  • Jeong, Jae-Han;Cho, Sung-Woo;Shin, Yoon-Cheol;Lee, Hee-Sung;Kim, Kun-Il
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.633-635
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    • 2008
  • Cardiac rupture after blunt chest trauma is a relatively uncommon diagnosis, and it is associated with a very high mortality rate. A 41-years-old man crashed his car into a guardrail and he was then transported to hospital. Although unstable vital signs are the most common symptoms of cardiac injury, this patient had stable vital signs. The chest CT scan showed pericardial effusion, and echocardiography did not clearly reveal cardiac tamponade, but the right atrium was slightly collapsed. Cardiac injury was suspected, and surgery was commenced for obtaining the diagnosis and treatment. A 2cm laceration at the junction of the left atrium and the lefl inferior pulmonary vein was discovered and this was repaired with $4{\sim}0$ Polypropylne monofilament sutures. We report here on the successful management of a patient with left atrial rupture following blunt chest trauma.

Asymptomatic Isolate Tricuspid Regurgitation with Chordae Tendineae Rupture Caused by Blunt Chest Injury

  • Kim, Min Hee;Kang, Hyun Jae;Jung, Byung Chun;Lee, Bong Ryeol;Jung, Ho Jin;Lee, Jun Young;Bae, Soo Hyun;Shin, Dong Woo
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.112-115
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    • 2013
  • The incidence and importance of tricuspid valve regurgitation after a blunt chest injury has risen with the increase in the number of automobile accidents and steering wheel traumas. This kind of injury has been reported more frequently in the last decade because of the better diagnostic procedures and understanding of the pathology. However, tricuspid valve regurgitation following a blunt chest injury can still be easily missed because most patients do not show symptoms at the time of the trauma. A 55-year-old male patient presented himself at our facility after suffering a chest injury from an automobile accident. His transthoracic echocardiography (TTE) revealed severe tricuspid valve regurgitation due to the prolapse of his anterior valve leaflet. We report a case of asymptomatic tricuspid regurgitation that developed after a blunt chest injury.

Traumatic Funnel Chest due to Blunt Trauma -A Case Report- (둔상에 의한 외상형 누두흉 -1례 보고-)

  • 조규석
    • Journal of Chest Surgery
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    • v.28 no.2
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    • pp.218-220
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    • 1995
  • This 51 years old male patient was admitted to the department of thoracic and cardiovascular surgery via OPD because of anterior chest pain. 7days before admission, He got the chest trauma after traffic accidents,the lateral chest roentgenogram showed complete transverse sternal fracture. He also complained of mild dyspnea. We also noticed that he had depressed anterior chest wall. It looks like funnel chest. The operative findings revealed dislocated & callus formations at the both 4th and 5th costochondral junction and transverse fracture of sternal body between 4th and 5th costochondral junction, the upper end of sternal fracture was situated below the lower end of sternal fracture. The two ends of sternal fracture were situated at the same level and reapproximated the two ends by two-interrupted wire sutures. The patient is well on the road to recovery after the operation.

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Single-Center Clinical Analysis of Traumatic Thoracic Aortic Injuries: A Retrospective Observational Study

  • Ma, Dae Sung;Jeon, Yang Bin
    • Journal of Trauma and Injury
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    • v.34 no.2
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    • pp.81-86
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    • 2021
  • Purpose: This study investigated the clinical outcomes of trauma patients with blunt thoracic aortic injuries at a single institution. Methods: During the study period, 9,501 patients with traumatic aortic injuries presented to Trauma Center of Gil Medical Center. Among them, 1,594 patients had severe trauma, with an Injury Severity Score (ISS) of >15. Demographics, physiological data, injury mechanism, hemodynamic parameters associated with the thoracic injury according to chest computed tomography (CT) findings, the timing of the intervention, and clinical outcomes were reviewed. Results: Twenty-eight patients had blunt aortic injuries (75% male, mean age, 45.9±16.3 years). The majority (82.1%, n=23/28) of these patients were involved in traffic accidents. The median ISS was 35.0 (interquartile range 21.0-41.0). The injuries were found in the ascending aorta (n=1, 3.6%) aortic arch (n=8, 28.6%) aortic isthmus (n=18, 64.3%), and descending aorta (n=1, 3.6%). The severity of aortic injuries on chest CT was categorized as intramural hematoma (n=1, 3.6%), dissection (n=3, 10.7%), transection (n=9, 32.2%), pseudoaneurysm (n=12, 42.8%), and rupture (n=3, 10.7%). Endovascular repair was performed in 71.4% of patients (45% within 24 hours), and two patients received surgical management. The mortality rate was 25% (n=7). Conclusions: Traumatic thoracic aortic injuries are life-threatening. In our experience, however, if there is no rupture and extravasation from an aortic injury, resuscitation and stabilization of vital signs are more important than an intervention for an aortic injury in patients with multiple traumas. Further study is required to optimize the timing of the intervention and explore management strategies for blunt thoracic aortic injuries in severe trauma patients needing resuscitation.

Bronchial Rupture by Blunt Chest Trauma -a case- (외상성 기관지 단절의 수술 치험 -1례-)

  • 정종화
    • Journal of Chest Surgery
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    • v.21 no.3
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    • pp.547-552
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    • 1988
  • Rupture of the main bronchus followed by blunt chest trauma is comparatively very rare. Early recognition of bronchial rupture and emergency thoracostomy and management is essential for reducing of morbidity and mortality and late complications. This case was 11 years old female who was a primary school student. The patient was sustained a crushing injury to her right hemithorax by traffic accident and had been taken emergency closed thoracostomy at her second intercostal space, midclavicular line at emergency room. In the course of the next 2 hours, the girl`s condition remained critical with tension pneumothorax and abnormal arterial blood gas analysis. Induction of anesthesia started 3 hours after the accident. During the general anesthesia, cardiac arrest was occurred and cardiac resuscitation was performed. Right upper lobectomy and end-to-end anastomosis of ruptured right main bronchus was performed. Postoperative course was satisfactory.

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Right Atrial Rupture Associated with Interatrial Septal Rupture due to Nonpenetrating Blunt Chest Trauma - A Case Report - (비관통성 흉부 둔상에 의한 심방중격 파열을 동반한 우심방 파열)

  • Kim, Seong-Ho;Jeong, Seong-Gyu
    • Journal of Chest Surgery
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    • v.24 no.10
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    • pp.987-992
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    • 1991
  • Severe cardiac injury due to nonpenetrating blunt chest trauma is not uncommon, but survival to reach the hospital is rare. Successful management of fatal cardiac rupture depends on the high suspicion and on the prompt exploration. In the patient presented, the interatrial septal rupture was found associated with the right atrial rupture and the patient was successfully treated under the cardiopulmonary bypass. Although many types of cardiac rupture cases survived have been reported in the literature, we have been unable to find the interatrial septal rupture case like us. We would therefore like to report our experience with surgical repair of nonpenetrating rupture of right atrium and interatrial septum.

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Complete Rupture of Cervical Trachea after Compressed Chest Injury in a Child (소아에서 흉부 압박상 후 발생한 경부기관의 완전 파열)

  • Byun, Joung-Hun;Cho, Sung-Ho;Cho, Sung-Rae
    • Journal of Chest Surgery
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    • v.40 no.4 s.273
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    • pp.309-312
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    • 2007
  • Cervical tracheal rupture is one of the rare injuries after blunt chest trauma, and this can be explained by several mechanisms. Early diagnosis and treatment of tracheal rupture after trauma can reduce the mortality and morbidity. We report here on a surgical experienced case of complete rupture of the cervical tracheal that was due to increased intra-tracheal pressure after a compression injury to the chest of an 8 years old child. We also include a review of the literature.

Surgical Repair of a Traumatic Tracheobronchial Injury in a Pediatric Patient Assisted with Venoarterial Extracorporeal Membrane Oxygenation

  • Suh, Jee Won;Shin, Hong Ju;Lee, Chang Young;Song, Seung Hwan;Narm, Kyoung Sik;Lee, Jin Gu
    • Journal of Chest Surgery
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    • v.50 no.5
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    • pp.403-406
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    • 2017
  • Tracheobronchial rupture due to blunt chest trauma is a rare but life-threatening injury in the pediatric population. Computed tomography (CT) is not always reliable in the management of these patients. An additional concern is that ventilation may be disrupted during surgical repair of these injuries. This report presents the case of a 4 -year-old boy with an injury to the lower trachea and carina due to blunt force trauma that was missed on the initial CT scan. During surgery, he was administered venoarterial extracorporeal membrane oxygenation (ECMO). Although ECMO is not generally used in children, this case demonstrated that the short-term use of ECMO during pediatric surgery is safe and can prevent intraoperative desaturation.

Traumatic Diaphragmatic Injuries -Report of 12 cases- (외상성 횡경막 손상치험 12예)

  • 이종국
    • Journal of Chest Surgery
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    • v.13 no.1
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    • pp.52-59
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    • 1980
  • Twelve cases of traumatic diaphragmatic injuries were treated at the Chosun University Hospital from Feb. 1977 to Inn. 1980. The following results were obtained. l. Sex ratio incidence was 5:1, which male patients were predominant. 2. The age distribution at these cases, were ranged from 16 to 43 years of age, and average age was 27 years. 3. Left sided traumatic diaphragmatic injuries were far more common than right, which approximately incidence of 5:1 diaphragmatic injuries were due to blunt trauma [7 cases-traffic accident, 1 case-fall down], and stab wound [4 cases] in etiology. 4. Surgical repairs were done through only thoracotomy incision in blunt trauma cases, and through each thoracic and abdominal incision same time in 2 cases of stab wound. 5. 2 cases {16.7%] of blunt trauma were died before operation at emergency room, and no man died during or following operation. An overall mortality was 16.7%.

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Delayed Diagnosis of Traumatic Rupture of Anterior Papillary Muscle of Tricuspid Valve; Importance of Trans-Esophageal Echocardiogram in the Evaluation of Major Blunt Chest Trauma

  • Bylsma, Ryan;Baldawi, Mustafa;Toporoff, Bruce;Shin, Matthew;Cochran-Yu, Meghan;Ramsingh, Davinder;Parwani, Purvi;Rabkin, David G.
    • Journal of Trauma and Injury
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    • v.34 no.2
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    • pp.136-140
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    • 2021
  • We present a case of delayed diagnosis of traumatic tricuspid valve rupture in a patient who was emergently brought to the operating room for repair of lacerations to the heart and liver without intraoperative transesophageal echocardiography (TEE). Initial postoperative transthoracic echocardiography (TTE) did not show structural pathology. One week later, TTE with better image quality showed severe tricuspid regurgitation. Subsequently, TEE clearly demonstrated rupture of the anterior papillary muscle and flail anterior tricuspid leaflet. The case description is followed by a brief discussion of the utility of TEE in the setting of blunt thoracic trauma.