The high mortality rate of blunt cardiac injuries is primarily due to the condition's severity and the challenges associated with pre-hospital survival. The absence of definitive diagnostic modalities necessitates prompt and adaptable surgical intervention. We present an 18-year-old male who sustained a right atrial blunt traumatic cardiac rupture following a motor vehicle collision. Despite initial stabilization with blood products and vasopressors and the necessitated emergent surgical exploration, the case required various surgical techniques, including anterolateral followed by an extension to a clamshell thoracotomy and laparotomy to manage the complex cardiac rupture and associated injuries. Furthermore, it underscores the critical nature of surgical incision in such patients and its impact on the overall prognosis. The successful outcome, highlighted by intraoperative decision-making and proper postoperative care, demonstrates that with timely and adaptable surgical approaches, even the most severe cases of traumatic blunt cardiac ruptures can be managed effectively.
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http://dx.doi.org/10.7759/cureus.49208 | DOI Listing |
J Trauma Acute Care Surg
December 2024
From the Emergency Surgical Services, Department of Surgery (J.G.P.), Santa Casa School of Medicine, Sao Paulo, Brazil; Division of Acute Care Surgery (R.C.), and Comparative Effectiveness and Clinical Outcomes Research Center (R.C.), Riverside University Health System Medical Center, Moreno Valley; and Loma Linda University School of Medicine (R.C.), Loma Linda, California.
Despite significant advances in trauma surgery in recent years, patients sustaining penetrating cardiac injuries still have an overall survival rate of 19%. A substantial number of deaths occur at the scene, while approximately 40% of those reaching trauma centers survive. To increase survival, the key factor is timely intervention for bleeding control, pericardial tamponade release, and definitive repair.
View Article and Find Full Text PDFKyobu Geka
September 2024
Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
Surgery for large tumors that occupy one side of the thoracic cavity requires a surgical strategy that considers not only the localization and size of the tumor but also tumor manipulation, access to adjacent vital organs such as the pulmonary arteriovenous, the tumor infiltration range, and combined organ resection. To perform safe and high-quality surgery, it is necessary to obtain a good surgical field, and determining the optimal surgical approach to use is also important. Thoracotomies include posterolateral thoracotomy, rib-cross thoracotomy, clamshell thoracotomy, hemi-clamshell thoracotomy, and transmanubrial osteomascular-sparing approach.
View Article and Find Full Text PDFInt J Surg Case Rep
December 2024
Adama Hospital Medical College, Adama, Ethiopia.
J Anesth Analg Crit Care
September 2024
London's Air Ambulance and Barts Health NHS Trust, Royal London Hospital, London, UK.
Background: The Chiari network mostly causes no symptoms but may occasionally be involved in thrombus formation in the right atrium. We present a case of right atrial thrombus discovered in the postoperative course of blunt cardiac rupture.
Case Presentation: A 19-year-old female injured in a motor vehicle accident was transported to the hospital in a state of shock.
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