Cardiac injury due to the rapid progress of the dislocation of rib fractures: A rare case that required urgent open reduction and internal rib fixation.
Chest trauma
Emergency thoracotomy
Hemothorax
Rib fracture
Surgical rib fixation
Journal
Respiratory medicine case reports
ISSN: 2213-0071
Titre abrégé: Respir Med Case Rep
Pays: England
ID NLM: 101604463
Informations de publication
Date de publication:
2019
2019
Historique:
received:
31
01
2019
revised:
09
04
2019
accepted:
09
04
2019
entrez:
4
5
2019
pubmed:
3
5
2019
medline:
3
5
2019
Statut:
epublish
Résumé
Most rib fractures are treated conservatively, but patients with severe trauma may require surgical treatment. We report a rare case of delayed pericardial injury due to a fractured rib stump. A 61-year-old man fell while riding a bicycle and was transferred to our hospital. A computed tomography (CT) scan showed mild rib fractures on the 4th-6th ribs, and he was hospitalized because of acute pain. A few days later, his respiratory condition had worsened. CT showed that the rib fractures progressed significantly, and the stump was in contact with the heart, so we performed an urgent surgical rib fixation. Operative findings revealed intrathoracic hemorrhage by the pericardial laceration because of the rib stump. The 4th-7th ribs were internally fixed using a screwless titanium metal plate, and he was discharged without complications on the 20th postoperative day. We experienced a rare case of pericardial injury caused by a rapid dislocation of rib fractures. Urgent surgical treatment was able to prevent a serious complication.
Sections du résumé
BACKGROUND
BACKGROUND
Most rib fractures are treated conservatively, but patients with severe trauma may require surgical treatment. We report a rare case of delayed pericardial injury due to a fractured rib stump.
CASE PRESENTATION
METHODS
A 61-year-old man fell while riding a bicycle and was transferred to our hospital. A computed tomography (CT) scan showed mild rib fractures on the 4th-6th ribs, and he was hospitalized because of acute pain. A few days later, his respiratory condition had worsened. CT showed that the rib fractures progressed significantly, and the stump was in contact with the heart, so we performed an urgent surgical rib fixation. Operative findings revealed intrathoracic hemorrhage by the pericardial laceration because of the rib stump. The 4th-7th ribs were internally fixed using a screwless titanium metal plate, and he was discharged without complications on the 20th postoperative day.
CONCLUSION
CONCLUSIONS
We experienced a rare case of pericardial injury caused by a rapid dislocation of rib fractures. Urgent surgical treatment was able to prevent a serious complication.
Identifiants
pubmed: 31049282
doi: 10.1016/j.rmcr.2019.100840
pii: S2213-0071(19)30038-3
pii: 100840
pmc: PMC6479153
doi:
Types de publication
Case Reports
Langues
eng
Pagination
100840Références
J Trauma. 2003 Mar;54(3):478-85
pubmed: 12634526
J Thorac Cardiovasc Surg. 2006 Jul;132(1):194-5
pubmed: 16798339
J Trauma Acute Care Surg. 2013 May;74(5):1363-6
pubmed: 23609291
Ann Vasc Surg. 2014 May;28(4):1035.e11-3
pubmed: 24529819
Am J Emerg Med. 2016 Apr;34(4):758.e1-3
pubmed: 26395222
J Trauma Acute Care Surg. 2016 Aug;81(2):397-9
pubmed: 27192468
J Trauma Acute Care Surg. 2017 Mar;82(3):618-626
pubmed: 28030502
Gen Thorac Cardiovasc Surg. 2018 Nov 10;:null
pubmed: 30415397
J Thorac Dis. 2018 Nov;10(Suppl 31):S3720-S3725
pubmed: 30505557
SAGE Open Med Case Rep. 2018 Dec 20;6:2050313X18819617
pubmed: 30788110
Ann Surg. 1987 Aug;206(2):200-5
pubmed: 3606246