Document Detail


Remembering a critical triad in severe deceleration injuries to the chest: report of a traumatic aortic rupture case.
MedLine Citation:
PMID:  20517756     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We aimed to present herein the case of a potentially preventable death involving traumatic aortic rupture and to develop a critical pathway for the management of isthmic aortic ruptures consistent with the available resources. A retrospective record review by a multidisciplinary panel of experts was done, and the probability of survival was estimated based on the Revised Trauma Score and Injury Severity Scale score. Literature review and expert consensus were used in a quality and safety analysis to develop a critical care pathway for future cases. A 32-year-old man, injured in a motorcycle accident, was referred to a trauma center in a state of shock. Thoracic aortic rupture was highly suspected. For educational purposes, the classic signs of a widened mediastinum, right tracheal deviation, and left-sided hemothorax (in a context of significant deceleration injury) are incorporated into an acute care triad for traumatic aortic rupture. In such cases, in the absence of poor access to aortography, we suggest (serial - if needed) contrast-enhanced chest computed tomography scanning for diagnosis confirmation and operative planning. Assumption of hemodynamic stability can be catastrophic, and transferring the patient to a second facility may endanger survival, when operative capacity exists at the initial trauma facility.
Authors:
Seyed-Farzad Mohammadi; Parisa Samimi; Seyed-Mehrdad Mohammadi; Ahmad Reza Soroush; Jerris R Hedges
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES     Volume:  16     ISSN:  1306-696X     ISO Abbreviation:  Ulus Travma Acil Cerrahi Derg     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-06-02     Completed Date:  2010-08-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101274231     Medline TA:  Ulus Travma Acil Cerrahi Derg     Country:  Turkey    
Other Details:
Languages:  eng     Pagination:  271-4     Citation Subset:  IM    
Affiliation:
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran.
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MeSH Terms
Descriptor/Qualifier:
Accidents, Traffic*
Adult
Aortic Rupture / complications*,  radiography,  surgery*
Deceleration
Fatal Outcome
Heart Rate
Hemodynamics
Humans
Male
Respiratory Distress Syndrome, Adult / etiology
Respiratory Physiological Phenomena
Shock / etiology
Systole / physiology
Tomography, X-Ray Computed / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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