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钝性胸部创伤后迟发性血胸：病例报告。

Delayed hemothorax following blunt thoracic trauma: a case report.

机构信息

Clinical Research Center, Fundación Valle del Lili, Kra 98 No. 18 - 49, Cali, 760032, Colombia.

School of Medicine, General Surgery, Universidad del Cauca, Popayán, 190003, Colombia.

出版信息

J Cardiothorac Surg. 2024 Jun 27;19(1):395. doi: 10.1186/s13019-024-02914-5.

DOI:10.1186/s13019-024-02914-5
PMID:38937751
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11210085/
Abstract

BACKGROUND

Late hemothorax is a rare complication of blunt chest trauma. The longest reported time interval between the traumatic event and the development of hemothorax is 44 days.

CASE PRESENTATION

An elderly patient with right-sided rib fractures from chest trauma, managed initially with closed thoracostomy, presented with a delayed hemothorax that occurred 60 days after initial management, necessitating conservative and then surgical intervention due to the patient's frail condition and associated complications.

CONCLUSIONS

This case emphasizes the clinical challenge and significance of delayed hemothorax in chest trauma, highlighting the need for vigilance and potential surgical correction in complex presentations, especially in the elderly.

摘要

背景

迟发性血胸是钝性胸部创伤的罕见并发症。有报道称，创伤事件与血胸发生之间的最长时间间隔为 44 天。

病例介绍

一位老年患者因胸部创伤导致右侧肋骨骨折，最初采用闭式胸腔引流治疗，在初始治疗后 60 天出现迟发性血胸，由于患者身体虚弱和相关并发症，需要进行保守和手术干预。

结论

本例强调了胸部创伤中迟发性血胸的临床挑战和意义，提示在复杂表现，特别是老年人中，需要保持警惕并可能需要进行手术纠正。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffa0/11210085/661341d38c98/13019_2024_2914_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffa0/11210085/4a04d2cc7375/13019_2024_2914_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffa0/11210085/83195a4c6d04/13019_2024_2914_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffa0/11210085/661341d38c98/13019_2024_2914_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffa0/11210085/4a04d2cc7375/13019_2024_2914_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffa0/11210085/83195a4c6d04/13019_2024_2914_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffa0/11210085/661341d38c98/13019_2024_2914_Fig3_HTML.jpg

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本文引用的文献

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Advanced age and increased CRP concentration are independent risk factors associated with Clostridioides difficile infection mortality.高龄和 C 反应蛋白浓度升高是与艰难梭菌感染死亡率相关的独立危险因素。
Sci Rep. 2020 Sep 7;10(1):14681. doi: 10.1038/s41598-020-71466-0.
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Delayed massive hemothorax requiring surgery after blunt thoracic trauma over a 5-year period: complicating rib fracture with sharp edge associated with diaphragm injury.5年期间钝性胸部创伤后需要手术治疗的延迟性大量血胸：伴有锐利边缘的肋骨骨折并发膈肌损伤。
Clin Exp Emerg Med. 2018 Mar 30;5(1):60-65. doi: 10.15441/ceem.16.190. eCollection 2018 Mar.
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钝性胸部创伤中血胸的管理：一项随机对照试验的研究方案
BMJ Open. 2018 Mar 3;8(3):e020378. doi: 10.1136/bmjopen-2017-020378.
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Longest delayed hemothorax reported after blunt chest injury.钝性胸部损伤后报告的最长延迟性血胸。
Am J Emerg Med. 2018 Jan;36(1):171.e1-171.e3. doi: 10.1016/j.ajem.2017.10.025. Epub 2017 Oct 16.
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Clinical prediction rule for delayed hemothorax after minor thoracic injury: a multicentre derivation and validation study.轻度胸部损伤后迟发性血胸的临床预测规则：一项多中心推导与验证研究
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Consensus statement: Surgical stabilization of rib fractures rib fracture colloquium clinical practice guidelines.共识声明：肋骨骨折的手术固定 肋骨骨折研讨会临床实践指南
Injury. 2017 Feb;48(2):307-321. doi: 10.1016/j.injury.2016.11.026. Epub 2016 Nov 27.
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Cohort study on the prevalence and risk factors for delayed pulmonary complications in adults following minor blunt thoracic trauma.成人轻度钝性胸部创伤后肺部并发症延迟发生的患病率及危险因素队列研究。
CJEM. 2014 Mar;16(2):136-43. doi: 10.2310/8000.2013.131043.
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9
Risk factors associated with complications and mortality in patients with Clostridium difficile infection.艰难梭菌感染患者并发症和死亡率相关的危险因素。
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Eur J Cardiothorac Surg. 2004 May;25(5):859-64. doi: 10.1016/j.ejcts.2004.01.044.