Park Hyun-Seok, Ryu Se-Min, Cho Seong-Joon, Park Sung-Min, Lim Sun-Hye
Department of Thoracic and Cardiovascular Surgery, Kangwon National University School of Medicine.
Department of Family Medicine, Kangwon National University School of Medicine.
Korean J Thorac Cardiovasc Surg. 2014 Aug;47(4):406-8. doi: 10.5090/kjtcs.2014.47.4.406. Epub 2014 Aug 5.
A 66-year-old male patient arrived at the emergency room with a crush injury to his chest. Multiple rib fractures, hemothorax on both sides, left scapular fracture, liver laceration, and retroperitoneal hematoma were found upon the radiologic examination. After closed thoracostomy, the patient had been initially admitted to the intensive care unit, but he was transferred to the general ward on the next day. On the 4th post-trauma day, the patient complained of severe pain and there was bloody drainage through the chest tube. This case is an exploration with the consideration of the possibility of major bleeding and the subsequent repair of the descending thoracic aorta. This case is regarded as a case in which the aorta wall was damaged as the sharp margin of the fractured ribs caused continuous irritation.
一名66岁男性患者因胸部挤压伤被送至急诊室。影像学检查发现多处肋骨骨折、双侧血胸、左侧肩胛骨骨折、肝裂伤和腹膜后血肿。在进行闭式胸腔造口术后，患者最初被收入重症监护病房，但次日转至普通病房。创伤后第4天，患者主诉剧痛，胸腔引流管有血性引流液。该病例考虑存在大出血可能性并对降主动脉进行后续修复而进行了探查。该病例被认为是由于肋骨骨折锐利边缘持续刺激导致主动脉壁受损的情况。
