MANAGEMENT OF CARDIAC PENETRATING INJURIES: A PROPOS OF A CASE

A 24 year old policeman presented with massive subcutaneous emphysema on the left side of the thorax with severe dyspnea after a motor vehicle accident. There were no clinical and radiographic signs of cardiac injury before the operation except the pneumediastinum. An incomplete laceration of the left ventricle and combined lung injury due to broken ribs were succesfully repaired. The rib fractures and pneumomediastinum may be considered as an alert sign for the possibility of concomitant cardiac injury after blunt thoracic trauma.

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  • /. Ivatury RR, Rohman M, Steichen FM, et at. Penetrating cardiac injuries: twenty-year
  • experience. Ann Surg 1987:53:310-31 7.
  • Wilson RF, Murray C, Antonenko DR. Mon- penetrating thoracic injuries. Surg Clin north Am 1977;57:17-36.
  • Monsour RA. Trauma to the chest. Chest Surg Clin M Am 1997;7:325-341.
  • Patetsios P, Priovolas S, Slesinger TL, Sclafani A, O'Meill P. Laceration of the left ventricle from rib fractures after blunt trauma. J Trauma 2000;49:771-773.
  • Goins WA, Ford Dll. The lethality of penetrating cardiac wounds. Am Surg 1996;62:987-993.
  • Henderson VJ, Smith S, Fry WR, et at. Cardiac injuries; analysis of an unselected series of 25 I cases. J Trauma 1994;36:34 I -348.
  • Zinck SE, Primack SL. Radiographic and CT findings in blunt chest trauma. J Thorac Imaging 2000;15:87-96.
  • Blostein PA, Hodgman CG. Computed tomography of the chest in blunt thoracic trauma: results of a prospective study. J Trauma 1997;43-13-18.
  • Healey M, Brown R, Fleiser D. Blunt cardiac injury: Is this diagnosis necessary ? J Trauma 1990;30.137-146.
  • Trinke JR, Toons RS, Franz JL, Arom RV, Grover FL. Affairs of the wounded heart: Penetrating cardiac wounds. Trauma 1979;19:467-472.