Dokoupil Marek, Marecová Klára, Uvíra Matěj, Joukal Marek, Mrázková Eva, Chmelová Jana, Handlos Petr
Department of Forensic Medicine, University Hospital Ostrava, CZ-708 52, Ostrava, Czech Republic.
Department of Epidemiology and Public Health, Faculty of Medicine, Ostrava University, CZ-703 00, Ostrava, Czech Republic.
Forensic Sci Med Pathol. 2019 Jun;15(2):272-275. doi: 10.1007/s12024-018-0069-5. Epub 2019 Jan 16.
Cardiac injury following blunt chest trauma is common in motor vehicle accidents due to a crush or blast injury. Severe cardiac trauma is associated with a very high mortality. If a cardiac injury develops several weeks after non-penetrating chest trauma, establishing a causal link between the traumatic event and the cardiac injury becomes complicated. This article reports a case of fatal delayed hemopericardium and hemothorax following a motor vehicle accident including blunt chest trauma 34 days prior to death. The cardiac injury was caused by displacement of a sharp irregular fragment of one of the decedents fractured ribs and the primary defect was sealed by blood clots. Subsequent bleeding occurred when the thrombus was displaced. Since the incidence of blunt high-energy chest injuries is relatively high, heart and large vessel injuries must be taken into account and a comprehensive examination needs to be done in order to prevent the delayed development of fatal complications.
钝性胸部创伤后的心脏损伤在机动车事故中很常见，原因是挤压伤或爆炸伤。严重的心脏创伤死亡率极高。如果在非穿透性胸部创伤数周后发生心脏损伤，确定创伤事件与心脏损伤之间的因果关系就会变得复杂。本文报告一例机动车事故后发生致命性迟发性心包积血和血胸的病例，死亡前34天有钝性胸部创伤。心脏损伤是由死者一根肋骨尖锐不规则碎片移位所致，原发性缺损被血凝块封闭。血栓移位时随后发生出血。由于钝性高能胸部损伤的发生率相对较高，必须考虑心脏和大血管损伤，并进行全面检查，以防止致命并发症的迟发。
