Ozel S Kerem, Kazez Ahmet
Department of Pediatric Surgery, Firat University Faculty of Medicine, 23119 Elaziğ, Turkey.
J Pediatr Surg. 2005 Oct;40(10):e17-9. doi: 10.1016/j.jpedsurg.2005.06.020.
A case of Horner syndrome diagnosed during the follow-up after major thoracic trauma is presented in this report. A 10-year-old boy was admitted to the emergency service with severe thoracic trauma with left clavicular and first rib fracture after a traffic accident. During the follow-up, myosis and ptosis were recognized in his left eye. Cranial tomography and neurological examination were all normal. The symptoms were thought to be caused by compression of the local hematoma to the cervical ganglia. After 30 days of conservative treatment with tube thoracostomies, he was discharged with his Horner syndrome. After 6 months of follow-up, the findings of Horner syndrome were found to be partially resolved. First rib fracture associated with Horner syndrome is very rarely seen in children, and only 2 cases were found in English-language literature. Our case seems to be the third reported case. Horner syndrome should be kept in mind in cases of first rib fractures. When head trauma is considered, as it can be mistaken with anisocoria, this knowledge may help the surgeon in differential diagnosis.
本报告介绍了1例在严重胸部创伤随访期间诊断出的霍纳综合征病例。一名10岁男孩因交通事故导致严重胸部创伤，伴有左锁骨和第一肋骨骨折，被送往急诊。在随访期间，发现他的左眼出现瞳孔缩小和上睑下垂。头颅断层扫描和神经学检查均正常。这些症状被认为是局部血肿压迫颈神经节所致。经过30天的胸腔闭式引流保守治疗后，他带着霍纳综合征出院。随访6个月后，发现霍纳综合征的症状部分得到缓解。与霍纳综合征相关的第一肋骨骨折在儿童中非常罕见，英文文献中仅发现2例。我们的病例似乎是第三例报道病例。对于第一肋骨骨折病例，应考虑到霍纳综合征。当考虑头部创伤时，由于可能与瞳孔不等大相混淆，这一认识可能有助于外科医生进行鉴别诊断。
