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Published on: November 29, 2018
[Rupture of the interventricular septum after the blunt trauma of thorax]
K Smejkal1, R Parízková, J Harrer
1Katedra válecné chirurgie, Fakulta vojenského zdravotnictví UO, Hradec Králové. k.smejkal@centrum.cz
Insights
A pediatric patient sustained a traumatic interventricular septal rupture after blunt chest trauma. Despite surgical repair, the patient experienced circulatory instability and electromechanical dissociation, leading to death.
Area of Science:
- Cardiology
- Trauma Surgery
- Pediatric Medicine
Background:
- Blunt thoracic injuries can cause severe cardiac complications.
- Interventricular septal defects are rare but critical consequences of trauma.
Observation:
- A pediatric patient presented with circulatory instability following a pedestrian-vehicle collision.
- Initial management focused on intra-abdominal injuries, but circulatory decompensation persisted.
- Transthoracic echocardiography revealed a traumatic rupture of the interventricular septum.
Findings:
- Surgical correction of the interventricular septal rupture was performed with initial positive results on echocardiography.
- Despite intervention, the patient developed electromechanical dissociation 27 hours post-admission.
- The case highlights the challenges in managing traumatic cardiac injuries in pediatric patients.
Implications:
- Early and accurate diagnosis of traumatic cardiac injuries is crucial.
- Management strategies for blunt thoracic trauma must consider potential cardiac complications.
- This case underscores the potential for delayed or fatal outcomes even after successful surgical repair.
Abstract:
Authors present the case of little patient with the dissection, pseudoaneurysm and finally a rupture of the interventricular septum after the blunt thracic injury. The patient was smitten as a pedestrian by a car and during the whole period of her stay in the hospital she was showing signs of circulatory instability. Due to the current intraabdominal injuries this circulatory decompensation was first assigned to hemoperitoneum, for which the girl was operated on about 3 hours after admission. Nevertheless, even after the abdminal cavity check, after the treatment of supreficial liver lacerations and intensive volume resuscitation the patient showed signs of insufficiency. Diagnosis was finally determined on the base of the transthoracic echocardiography (TTE), which proved the traumatic rupture of interventricular septum. The operation followed correcting the defect, which was performed with a good result according to the TTE postoperatively. Nevertheless, 27 hours after the admission the patient died due to the electromechanical dissociation. In the discussion the authors then evoke a number of papers concerning the same topic.
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