医学
剖腹探查术
外科
穿透伤
心内注射
心脏压塞
神秘的
开胸手术
创伤中心
急诊分诊台
卫生棉条
刺伤
体外循环
剖腹手术
医疗急救
迟钝的
心脏病学
回顾性队列研究
替代医学
病理
作者
Jaclyn N. Portelli Tremont,Andrea Ward,Amirreza T Motameni
出处
期刊:American Surgeon
[SAGE]
日期:2022-01-02
卷期号:: 000313482110540-000313482110540
标识
DOI:10.1177/00031348211054064
摘要
Penetrating cardiac injury remains one of the deadliest traumatic injuries. Early identification and definitive operative management are critical tenets for patient survival; however, variable clinical presentations can obscure the diagnosis. Here, we present the case of a 58-year-old obese man who presented to an urban level 1 trauma center with multiple stab wounds to the epigastrium and lateral left chest in the axillary line with an unknown weapon. The patient was taken emergently to the operating room for exploratory laparotomy, median sternotomy, and attempted repair of multiple full-thickness lacerations of the right ventricle and left and right atrium. This case demonstrates several instructive points. First, a high index of suspicion for penetrating cardiac injury is needed, especially during triage of multiple injuries. Second, careful release of cardiac tamponade is critical. Finally, there are several indications for cardiopulmonary bypass, which include multichambered injuries, uncontrollable hemorrhage, and concern for intracardiac injury.
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