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[Penetrating stab injury to the heart with unusually long survival]
M G Perdekamp1, U N Riede, S Pollak
1Institut für Rechtsmedizin der Universität Freiburg.
A 19-year-old man was injured with a kitchen knife by a singular stab to the left anterior thoracic wall. Initial medical treatment was limited to the extrathoracic soft tissue wound and volume replacement by infusion. Subsequently the circulatory situation stabilized and the patient seemed to be out of danger. 3 1/2 hours after treatment a hemorrhagic shock developed, which resulted in the death of the patient while an emergency thoracotomy was still being performed. At autopsy a penetrating stab wound was detected in the left ventricle with the wound track being partially blocked by thrombotic material. The pathophysiological causes of the atypical clinical course are described and discussed with reference to the relevant literature.
A 19-year-old man was injured with a kitchen knife by a singular stab to the left anterior thoracic wall. Initial medical treatment was limited to the extrathoracic soft tissue wound and volume replacement by infusion. Subsequently the circulatory situation stabilized and the patient seemed to be out of danger. 3 1/2 hours after treatment a hemorrhagic shock developed, which resulted in the death of the patient while an emergency thoracotomy was still being performed. At autopsy a penetrating stab wound was detected in the left ventricle with the wound track being partially blocked by thrombotic material. The pathophysiological causes of the atypical clinical course are described and discussed with reference to the relevant literature.
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