一个隐藏的眼:在没有外部胸部创伤的情况下,在的右心房附属体破裂后的生存率
Phillip Jenkins1, Victor Andujo1, Philbert Van1
1Oregon Health & Science University, Department of Surgery, Division of Trauma, Critical Care, and Acute Care Surgery, Portland, OR, 97239, United States of America.
心破裂很罕见,在没有胸部创伤的情况下很难诊断. 在一名行人碰撞患者的右心房附属体破裂的早期手术修复导致了良好的康复,突出了高度怀疑的必要性.
科学领域:
- 创伤外科 手术 创伤外科
- 心胸外科手术 心胸外科手术
- 紧急医疗 紧急医疗
背景情况:
- 软心室破裂是不常见的,经常是致命的.
- 当没有外部胸部创伤时,诊断是具有挑战性的.
- 在特定的创伤场景中,这些伤害需要高度的怀疑指数.
研究的目的:
- 报告一个右心房附属体破裂与心周栓塞的病例.
- 为了强调隐秘的无形心脏损伤的诊断挑战.
- 突出早期手术干预的重要性.
主要方法:
- 案例报告:一名17岁的男性行人被车辆撞上.
- 最初的评估包括血液动力学评估和针对创伤的超声波 (FAST) 检查的集中评估.
- 新兴的探索性腹腔切除术,心周窗口和心脏修复的中枢骨切除术.
主要成果:
- 患者患有右心房附属体破裂和心周栓塞.
- 尽管没有外部胸部损伤,但血液动力学不稳定导致了外科手术.
- 在第12天成功修复了心房缺陷,并恢复,在第12天出院.
结论:
- 在高能量创伤后,即使没有胸部损伤,也应该怀疑不解释性低血压.
- 图像/检查和临床表现之间的不一致发现需要进一步调查.
- 在这些罕见病例中,迅速的手术修复对于生存至关重要.
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