BACKGROUND Post-traumatic blunt pericardial injury is a rare condition with only a few reported cases which were generally diagnosed during initial examinations upon admission.However,pericardial injuries not bad enou...BACKGROUND Post-traumatic blunt pericardial injury is a rare condition with only a few reported cases which were generally diagnosed during initial examinations upon admission.However,pericardial injuries not bad enough to dislocate the heart may only cause intermittent electrocardiogram(ECG)changes or be asymptomatic.CASE SUMMARY In this case,we report a blunt pericardial injury undetected on preoperative transthoracic echocardiography and chest computed tomography.We misjudged intermittent ECG changes and blood pressure fluctuations as minor symptoms resulting from cardiac contusion and did not provide intensive treatment.The pericardial injury was found incidentally during surgical stabilization of rib fractures and was successfully repaired.CONCLUSION Post-traumatic blunt pericardial ruptures should be considered in patients with blunt chest trauma showing abnormal vital signs and ECG changes.展开更多
Rib fracture is the most common injury in chest trauma.Most of patients with rib fractures were treated conservatively,but up to 50%of patients,especially those with combined injury such as flail chest,presented chron...Rib fracture is the most common injury in chest trauma.Most of patients with rib fractures were treated conservatively,but up to 50%of patients,especially those with combined injury such as flail chest,presented chronic pain or chest wall deformities,and more than 30%had long-term disabilities,unable to retain a full-time job.In the past two decades,surgery for rib fractures has achieving good outcomes.However,in clinic,there are still some problems including inconsistency in surgical indications and quality control in medical services.Before the year of 2018,there were 3 guidelines on the management of regional traumatic rib fractures were published at home and abroad,focusing on the guidance of the overall treatment decisions and plans;another clinical guideline about the surgical treatment of rib fractures lacks recent related progress in surgical treatment of rib fractures.The Chinese Society of Traumatology,Chinese Medical Association,and the Chinese College of Trauma Surgeons,Chinese Medical Doctor Association organized experts from cardiothoracic surgery,trauma surgery,acute care surgery,orthopedics and other disciplines to participate together,following the principle of evidence-based medicine and in line with the scientific nature and practicality,formulated the Chinese consensus for surgical treatment of traumatic rib fractures(STTRF 2021).This expert consensus put forward some clear,applicable,and graded recommendations from seven aspects:preoperative imaging evaluation,surgical indications,timing of surgery,surgical methods,rib fracture sites for surgical fixation,internal fixation method and material selection,treatment of combined injuries in rib fractures,in order to provide guidance and reference for surgical treatment of traumatic rib fractures.展开更多
文摘BACKGROUND Post-traumatic blunt pericardial injury is a rare condition with only a few reported cases which were generally diagnosed during initial examinations upon admission.However,pericardial injuries not bad enough to dislocate the heart may only cause intermittent electrocardiogram(ECG)changes or be asymptomatic.CASE SUMMARY In this case,we report a blunt pericardial injury undetected on preoperative transthoracic echocardiography and chest computed tomography.We misjudged intermittent ECG changes and blood pressure fluctuations as minor symptoms resulting from cardiac contusion and did not provide intensive treatment.The pericardial injury was found incidentally during surgical stabilization of rib fractures and was successfully repaired.CONCLUSION Post-traumatic blunt pericardial ruptures should be considered in patients with blunt chest trauma showing abnormal vital signs and ECG changes.
基金supported by the National Trauma Regional Medical Center Major Research Project(co-built by the Municipal Commission)(jjzx2021-gjcsqyylzx01)。
文摘Rib fracture is the most common injury in chest trauma.Most of patients with rib fractures were treated conservatively,but up to 50%of patients,especially those with combined injury such as flail chest,presented chronic pain or chest wall deformities,and more than 30%had long-term disabilities,unable to retain a full-time job.In the past two decades,surgery for rib fractures has achieving good outcomes.However,in clinic,there are still some problems including inconsistency in surgical indications and quality control in medical services.Before the year of 2018,there were 3 guidelines on the management of regional traumatic rib fractures were published at home and abroad,focusing on the guidance of the overall treatment decisions and plans;another clinical guideline about the surgical treatment of rib fractures lacks recent related progress in surgical treatment of rib fractures.The Chinese Society of Traumatology,Chinese Medical Association,and the Chinese College of Trauma Surgeons,Chinese Medical Doctor Association organized experts from cardiothoracic surgery,trauma surgery,acute care surgery,orthopedics and other disciplines to participate together,following the principle of evidence-based medicine and in line with the scientific nature and practicality,formulated the Chinese consensus for surgical treatment of traumatic rib fractures(STTRF 2021).This expert consensus put forward some clear,applicable,and graded recommendations from seven aspects:preoperative imaging evaluation,surgical indications,timing of surgery,surgical methods,rib fracture sites for surgical fixation,internal fixation method and material selection,treatment of combined injuries in rib fractures,in order to provide guidance and reference for surgical treatment of traumatic rib fractures.
