Thoracic Impalement: Lessons Learned

被引：1

作者：

Tannheimer, M. ^{[1
]}

Soelter, J. ^{[1
]}

Stahl, M. ^{[2
]}

Pohl, A. ^{[3
]}

Schmidt, R. ^{[1
]}

机构：

[1] Bundeswehrkrankenhaus Ulm, Klin Allgemein Viszeral & Thoraxchirurg, D-89081 Ulm, Germany

[2] Bundeswehrkrankenhaus Ulm, Abt Innere Med, D-89081 Ulm, Germany

[3] Bundeswehrkrankenhaus Ulm, Abt Anasthesie & Intens Med, D-89081 Ulm, Germany

来源：

NOTARZT | 2014年 / 30卷 / 04期

关键词：

impalement injury; crossclamping; thoracic perforation; spontaneous breathing; explorative laparotomy; SHAFT FRACTURES; INJURIES; SURGERY; TRAUMA; MANAGEMENT; POLYTRAUMA; FEMUR;

D O I：

10.1055/s-0033-1360005

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

This paper presents the case report of a 54-years old truck driver who suffered from a transthoracic impalement injury after a rear-end collision accident. We analysed the transportation under spontaneous breathing, the diagnostic procedures in the shock room as well as the immediately performed procedures. During surgical treatment, temporary compression of the thoracic aorta was necessary because of cardiopulmonal instability of the patient. On basis of the treatment of this highly dramatic injury, the following three striking conclusions are deduced and are further discussed on the background of the current literature. 1. Compression of the thoracic aorta is highly effective. 2. explorative laparotomy provides security. 3. A perforating item should be shortened sufficiently.

引用

页码：169 / 172

页数：4

共 18 条

[1] Damage Control Orthopedics. What is the current situation? [J].

Bouillon, B. ;

Rixen, D. ;

Maegele, M. ;

Steinhausen, E. ;

Tjardes, T. ;

Paffrath, T. .

UNFALLCHIRURG, 2009, 112 (10) :860-+

[2] Abdominal ultrasound is an unreliable modality for the detection of hemoperitoneum in patients with pelvic fracture [J].

Friese, Randall S. ;

Malekzadeh, Stephen ;

Shafi, Shahid ;

Gentilello, Larry M. ;

Starr, Adam .

JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2007, 63 (01) :97-102

[3] Polytrauma - pathophysiology and management principles [J].

Gebhard, F. ;

Huber-Lang, M. .

LANGENBECKS ARCHIVES OF SURGERY, 2008, 393 (06) :825-831

[4] IMPALEMENT INJURIES TO THE THORAX AS A RESULT OF MOTOR-VEHICLE ACCIDENTS [J].

HYDE, MR ;

SCHMIDT, CA ;

JACOBSON, JG ;

VYHMEISTER, EE ;

LAUGHLIN, LL .

ANNALS OF THORACIC SURGERY, 1987, 43 (02) :189-190

[5]

KIRSHNER RL, 1986, J CARDIOVASC SURG, V27, P185

[6] Reality of care based on the data from the Trauma Registry of the German Society of Trauma Surgery [J].

Lefering, R. ;

Paffrath, T. .

UNFALLCHIRURG, 2012, 115 (01) :30-32

[7] Current diagnostics for intra-abdominal trauma [J].

Nast-Kolb, D ;

Bail, HJ ;

Taeger, G .

CHIRURG, 2005, 76 (10) :919-926

[8] The Treatment of Patients With Severe and Multiple Traumatic Injuries [J].

Neugebauer, Edmund A. M. ;

Waydhas, Christian ;

Lendemans, Sven ;

Rixen, Dieter ;

Eikermann, Michaela ;

Pohlemann, Tim .

DEUTSCHES ARZTEBLATT INTERNATIONAL, 2012, 109 (06) :102-U44

[9] Optimal duration of primary surgery with regards to a "borderline"-situation in polytrauma patients [J].

Pape, HC ;

Stalp, M ;

Dahlweid, M ;

Regel, G ;

Tscherne, H .

UNFALLCHIRURG, 1999, 102 (11) :861-869

[10] Protocol for a randomized controlled trial on risk adapted damage control orthopedic surgery of femur shaft fractures in multiple trauma patients [J].

Rixen, Dieter ;

Steinhausen, Eva ;

Sauerland, Stefan ;

Lefering, Rolf ;

Meier, Matthias ;

Maegele, Marc G. ;

Bouillon, Bertil ;

Neugebauer, Edmund A. M. .

TRIALS, 2009, 10

← 1 2 →