Pinni Suraj, Kumar Vineet, Dharap Satish Balkrishna
Post Graduate Resident, Department of General Surgery, Lokmanya Tilak Municipal Medical College and General Hospital , Sion, Mumbai, Maharashtra, India .
Assistant Professor, Department of General Surgery, Lokmanya Tilak Municipal Medical College and General Hospital , Sion, Mumbai, Maharashtra, India .
J Clin Diagn Res. 2016 Nov;10(11):PD27-PD28. doi: 10.7860/JCDR/2016/22220.8894. Epub 2016 Nov 1.
Blunt Cardiac Rupture (BCR) is a life threatening injury. Majority of patients do not reach the hospital and in those who reach the emergency department, timely diagnosis and treatment is a challenge. The case is about a patient with multiple blunt injuries who presented in shock. Cardiac tamponade was suspected on clinical grounds and on evidence of mediastinal widening on radiograph. In the absence of songography, the diagnosis was confirmed by subxiphoid pericardial window. Emergency thoracotomy revealed a right atrial appendage rupture which was surgically corrected. The patient also underwent splenectomy for grade IV splenic injury. Liver injury, pubic diastasis and tibial spine avulsion fracture was managed conservatively. He recovered well. Systematic observance of trauma resuscitation guidelines can help salvage patients with life threatening complex injuries even in the absence of specialized imaging investigations.
钝性心脏破裂（BCR）是一种危及生命的损伤。大多数患者无法到达医院，而那些到达急诊科的患者，及时诊断和治疗是一项挑战。该病例是一名有多处钝性损伤且出现休克的患者。基于临床情况及X线片显示纵隔增宽的证据怀疑有心包填塞。在没有超声检查的情况下，通过剑突下心包开窗术确诊。急诊开胸手术发现右心耳破裂并进行了手术修复。患者还因IV级脾损伤接受了脾切除术。肝损伤、耻骨联合分离和胫骨棘撕脱骨折采取保守治疗。他恢复良好。即使在没有专业影像检查的情况下，系统遵循创伤复苏指南也有助于挽救有危及生命的复杂损伤的患者。
