Ohn May Honey, Ohn Khin Maung
Cardiology Department, University Hospital Lewisham, London, UK
Surgery Department, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia.
BMJ Case Rep. 2021 May 31;14(5):e241408. doi: 10.1136/bcr-2020-241408.
Poland's syndrome (PS) is a rare developmental anomaly that can manifest mild (pectoralis muscles involvement) to severe deformities (rib hypoplasia and hand deformities). We report a case of 69-year-old man who presented to the emergency department with a traumatic chest injury after a fall. It was initially thought to have a significant chest injury as the trauma survey revealed a palpable defect and tenderness in the right anterior chest wall. There was also a symbrachydactyly deformity in the right hand. CT of the chest showed lack of right pectoralis muscles, which were consistent with PS. This case highlights the importance of gathering detail history in adult trauma patients such as congenital disorder especially in the presence of bony deformity. With possibilities of several traumatic conditions in trauma patients eliminated, one can expand the non-traumatic differential, keeping in mind the possibility of a congenital disorder that can mimic traumatic chest injury.
波兰综合征（PS）是一种罕见的发育异常，可表现为轻度（胸肌受累）至重度畸形（肋骨发育不全和手部畸形）。我们报告一例69岁男性，因跌倒后胸部外伤就诊于急诊科。最初认为有严重的胸部损伤，因为创伤检查发现右前胸壁有可触及的缺损和压痛。右手还有并指畸形。胸部CT显示右侧胸肌缺如，这与波兰综合征相符。该病例强调了在成年创伤患者中收集详细病史的重要性，尤其是存在骨骼畸形时先天性疾病的病史。在排除创伤患者可能存在的多种创伤性疾病后，考虑到先天性疾病可能模仿创伤性胸部损伤的可能性，可以扩大非创伤性鉴别诊断范围。
