钝性胸部创伤后肋骨骨折断端穿透心脏致心脏破裂：一例报告
Cardiac rupture caused by penetration of the heart by fractured costal cartilage following blunt chest trauma: A case report.
作者信息
Hattori Masao, Akita Mayo, Mori Kotaro, Ichikawa Michitaro, Takeshige Kanako, Kamijo Hiroshi, Mochizuki Katsunori, Imamura Hiroshi, Tanaka Haruki, Takeda Tetsu
机构信息
Department of Emergency and Critical Care Medicine Shinshu University School of Medicine Matsumoto Japan.
Department of Cardiovascular Surgery Shinshu University School of Medicine Matsumoto Japan.
出版信息
Acute Med Surg. 2024 Nov 24;11(1):e70024. doi: 10.1002/ams2.70024. eCollection 2024 Jan-Dec.
BACKGROUND
Cardiac rupture is rare but has a high mortality rate. Cardiac rupture due to blunt trauma is generally caused by the heart being pinched into the bony thorax.
CASE PRESENTATION
A 90-year-old man in shock was transported to the hospital after his precordium was stepped on by a cow. He developed right atrial rupture from penetration of the heart by fractured and calcified costal cartilage, with massive hemothorax, hemorrhagic shock, and respiratory failure. We immediately performed cardiac injury repair. The patient was discharged without sequelae.
CONCLUSION
Emergency physicians should be aware that secondary cardiac rupture can show a penetrating injury-like presentation due to calcified costal cartilage caused by blunt chest trauma.
背景
心脏破裂虽罕见，但死亡率很高。钝性创伤导致的心脏破裂通常是由于心脏被挤压进骨性胸廓所致。
病例介绍
一名90岁休克男性在被牛踩踏前胸后被送往医院。他因骨折并钙化的肋软骨穿透心脏而发生右心房破裂，伴有大量血胸、失血性休克和呼吸衰竭。我们立即进行了心脏损伤修复。患者出院时无后遗症。
结论
急诊医生应意识到，钝性胸部创伤导致的钙化肋软骨可使继发性心脏破裂呈现出类似穿透伤的表现。
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