UNSTABLE THORAX AND HEART INJURY – CASE REPORT

Czech version

Authors: Ladislav Lukáč; Leopold Pleva; Petr Prusenovský
Authors‘ workplace: Traumacentre University Hospital Ostrava ; Traumatologické centrum FN Ostrava
Published in: Úraz chir. 15., 2007, č.1

Overview

The authors describe a case of 36 old man, who was run down as a pedestrian by car. During admission to hospital a multiple organ injury was discovered, including left-side pneumothorax and hemothorax with multiple ribs fracture, fracture of left proximal humerus and left femoral shaft and left-side pelvis fracture, a little liquid collection around the spleen. Left-side thoracic drainage was made with a sole evacuation of 800 ml blood loss, patient´s transport to the operating theatre with following stabilization of humeral and femoral fractures. During the whole operation a patient was hemodynamic stable a blood loss from a thoracic drain was about 50 ml per hour. A short time after finishing of fractures stabilisation an improvement of blood secretion has arisen in thoracic drain (1000 ml per hour) with sings of patient´s hemodynamic instability. There was a posterolateral thoracotomy made with discovery of the left ventricular perforation of heart, on lateral side of the heart apex with pericardial perforation about 1 cm, we did pericardiotomy in the same place (Fig. 1). Central myocardial wall perforation about 1 cm, was found in myocardial contusion focus with diameter about 3 cm, suture by prolene 3/0 across Portex patch was made (Fig. 2). After treatment of heart bleeding we did stabilisation of chest wall by Medin system of chest wall plating so called stabilisation on retreat (Fig. 3). Patient healed up primary and after stabilisation of his status, he was transfered to the physiotherapy institution.

Key words:
blunt chest injury, unstable thorax, heart injury.

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Labels

Surgery Traumatology Trauma surgery

Injury of circular saw – polytrauma

Treatment of the pathologic fractures through unicameral bone cysts in children

Article was published in

Trauma Surgery

2007 Issue 1