Ishay Shlomo Y, Raichel Lior, Tabo Limor Y, Semyonov Michael, Barsky Guy, Acker Asaf, Shaked Gad, Sahar Gideon
Department of cardiothoracic surgery, Soroka University Medical Center, Israel.
Department of anesthesia, Soroka University Medical Center, Israel.
Trauma Case Rep. 2021 Dec 23;37:100596. doi: 10.1016/j.tcr.2021.100596. eCollection 2022 Feb.
Flail chest is a common injury in blunt trauma which is usually treated with analgesia, oxygen, and other conservative measures. In more severe cases mechanical ventilation and surgical stabilization of rib fractures (SSRF) may be warranted. Penetrating injury to the heart or great vessels due to rib fractures however, is much less common. Here we present a 33 year old male that was admitted to the Emergency department (ED) after a horse riding accident, demonstrating severe shock. Emergency computerized tomography scan showed multiple bilateral displaced rib fractures, Left hemothorax and possibly a penetrating injury to the left side of the heart by one of the ribs. Notably, no significant pericardial effusion was demonstrated. In addition, a grade V splenic injury was diagnosed. A Joined thoracic and abdominal emergent surgical treatment was successfully carried out and the patient survived and fully recovered.
连枷胸是钝性创伤中的常见损伤，通常采用镇痛、输氧及其他保守措施进行治疗。在更严重的情况下，可能需要进行机械通气和肋骨骨折的手术固定（SSRF）。然而，肋骨骨折导致的心脏或大血管穿透伤则要少见得多。在此，我们报告一名33岁男性，在骑马事故后被送往急诊科（ED），表现为严重休克。急诊计算机断层扫描显示双侧多处肋骨移位骨折、左侧血胸，且其中一根肋骨可能对心脏左侧造成了穿透伤。值得注意的是，未发现明显的心包积液。此外，还诊断出脾脏V级损伤。成功实施了胸腹部联合急诊手术治疗，患者存活并完全康复。
