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Open pneumothorax

An open pneumothorax after a stab wound to the back

Vicente Scopel e Jorge Carlotto. Serviço de Cirurgia Geral e do Trauma do Hospital da Cidade - Passo Fundo - RS – Brasil


Aortic Arch stab wound - Pledget repair

Cervicosternotomy revealing haematoma in aorta, innominate trunk and left common carotid artery

César Benítez Pozo ,Victor Vasquez ,Pamela Pedrero ,José Salinas .Equipo Cirugia Torax y Cardiaca y S Urgencia Hospital San Juan de Dios Universidad de Chile .Santiago de Chile


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Case Presentations

Traumatic diaphragmatic Injury (Right side)

b banga, December 22, 2010

A middle aged female presented with multiple # ribs and right side haemothorax after a road accident. A chest tube was put in to drain the hemothorax. She was comfortable, no respiratory distress and maintaining the oxygen saturation without oxygen supplementation. There is decrease air entry at base and check X-ray revealed markedly elevated diaphragm on Rt. Side.

C.T.Chest-suspicion of traumatic diaphragmatic hernia with herniation of liver in thorax. I planned lateral thoracotomy through 7th I.C.space. Before opening I put Laparoscope through chest tube site and confirmed the diagnosis. Liver and a part of colon were in thorax. After opening both structures could be reduced easily. Rent in diaphragm repaired with 1/0 Prolene suture. Post operative – uneventful recovery

A Stab Wound to the Right Auriculoventricular Junction

sam zeraatian nejad davani, October 18, 2010

A patient came to our hospital trauma center with profound shock following a stab attack. The stab entry point was the right anterior chest wall. The injury was repaired and the patient discharged following a good recovery.

Research Blog Entries

PubMed ID: 19680160
J Trauma. 2009 Aug 12.
Authors: Teixeira PG, Inaba K, Oncel D, Dubose J, Chan L, Rhee P, Salim A, Browder T, Brown C, Demetriades D.

Abstract:

OBJECTIVE:: Because of its rarity and high rate of mortality, traumatic blunt cardiac rupture (BCR) has been poorly studied. The objective of this study was to use the National Trauma Data Bank to review the epidemiology and outcomes associated with traumatic BCR. METHODS:: After approved by the institutional review board, the National Trauma Data Bank (version 5.0) was queried for all BCR occurring between 2000 and 2005. Demographics, clinical injury data, interventions, and outcomes were abstracted for each patient. Statistical analysis was performed using an unpaired Student's t test or Mann-Whitney U test to compare means and chi analysis to compare proportions. Stepwise logistic regression analysis was performed to identify independent predictors of inhospital mortality. RESULTS:: Of 811,531 blunt trauma patients, 366 (0.045%) had a BCR of which 334 were available for analysis, with the mean age of 45 years, 65% were men, and their mean Injury Severity Score was 58 +/- 19. The most common mechanism of injury was motor vehicle collision (73%), followed by pedestrian struck by auto (16%), and falls from height (8%). Twenty-one patients (6%) died on arrival and 140 (42%) died in the emergency room. The overall mortality for patients arriving alive to hospital was 89%. Of the patients surviving to operation, 42% survived >24 hours of which 87% were discharged. Survivors were significantly younger (39 vs. 46 years, p = 0.04), had a lower Injury Severity Score (47 vs. 56, p = 0.02), higher Glasgow Coma Scale (10 vs. 6, p < 0.001), and were more likely to present with an systolic blood pressure >/=90 mm Hg (p = 0.01). Nevertheless, none of these factors was found to be an independent risk factor for mortality. CONCLUSION:: BCR is an exceedingly rare injury, occurring in 1 of 2400 blunt trauma patients. In patients arriving alive to hospital, traumatic BCR is associated with a high mortality rate, however, is not uniformly fatal.