钝性创伤后肋骨骨折渐进性移位导致的延迟性胸壁血肿。
Delayed chest wall hematoma caused by progressive displacement of rib fractures after blunt trauma.
作者信息
Sato Nobuhiro, Sekiguchi Hiroshi, Hirose Yasuo, Yoshida Satoru
机构信息
Department of Emergency and Critical Care Medicine, Niigata City General Hospital, 463-7, Shumoku, Chuo-ku, Niigata 950-1197, Japan.
Department of Emergency and Critical Care Medicine, Uonuma Kikan Hospital, 4132, Urasa, Minamiuonuma, Niigata 949-7302, Japan.
出版信息
Trauma Case Rep. 2016 Jun 14;4:1-4. doi: 10.1016/j.tcr.2016.05.001. eCollection 2016 Jun.
Rib fracture is a common injury resulting from blunt thoracic trauma. Although hemothorax and pneumothorax are known delayed complications of rib fracture, delayed chest wall hematoma has rarely been reported. We discuss the case of an 81-year-old woman who was not undergoing antiplatelet or anticoagulant therapy who presented to our emergency department after a traffic injury. This patient had a nondisplaced rib fracture that went undetected on the initial computed tomography scan; the development of progressive displacement led to hemorrhagic shock due to delayed chest wall hematoma. The chest wall hematoma was effectively diagnosed and treated via contrast-enhanced computed tomography and angiographic embolization. This case highlights the possibility of this potential delayed complication from a common injury such as a rib fracture.
肋骨骨折是钝性胸部创伤导致的常见损伤。虽然血胸和气胸是已知的肋骨骨折延迟并发症，但延迟性胸壁血肿鲜有报道。我们讨论了一例81岁女性患者的病例，该患者未接受抗血小板或抗凝治疗，在交通伤后就诊于我们的急诊科。该患者有一处无移位的肋骨骨折，在最初的计算机断层扫描中未被发现；由于延迟性胸壁血肿导致骨折逐渐移位，进而引发失血性休克。通过增强计算机断层扫描和血管造影栓塞有效地诊断和治疗了胸壁血肿。该病例凸显了肋骨骨折这种常见损伤可能出现这种潜在延迟并发症的可能性。
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