Gumpert Rainer, Archan Sylvia, Matzi Veronika, Smolle-Jüttner Freyja-Maria
Department of Trauma Surgery, Medical University of Graz, 8036 Graz, Austria.
Am J Emerg Med. 2009 Oct;27(8):1024.e1-2. doi: 10.1016/j.ajem.2008.12.033.
Cardiac luxation after blunt trauma is a rare condition that carries a high mortality rate. We report a case of a left pericardial rupture with partial dislocation of the heart into the left pleural cavity and cardiac strangulation in a polytraumatized patient after a severe motor vehicle accident. This case is of special interest because the patient not only had cardiovascular compromise but was also actually in cardiac arrest and being resuscitated when an emergency repositioning of the heart through the diaphragm in the setting of damage control laparotomy restored circulation. This report stresses the need for a high index of suspicion for accurate early diagnosis of pericardial rupture.
钝性创伤后心脏脱位是一种罕见的疾病，死亡率很高。我们报告一例严重机动车事故后多发伤患者，发生左心包破裂，心脏部分脱入左胸腔并出现心脏绞窄。该病例特别引人关注，因为患者不仅存在心血管功能障碍，而且实际上处于心脏骤停状态，在损伤控制剖腹术过程中通过膈肌紧急重新定位心脏后恢复了循环。本报告强调，对于心包破裂的准确早期诊断需要高度的怀疑指数。
