Delayed diagnosis of traumatic ventricular septal perforation in penetrating chest injury: hematoma formation in the ventricular septum in CT suggests perforation

被引:3
作者
Shioya, Nobuki [1 ]
Inoue, Nozomu [1 ]
Muto, Harutatsu [2 ]
Tomita, Akiko [1 ]
Tsukamoto, Yuki [1 ]
Kawashima, Naonori [1 ]
Hazama, Koji [1 ]
Shichinohe, Yasuo [1 ]
机构
[1] Natl Hosp Org, Hokkaido Med Ctr, Crit Care & Emergency Ctr, Nishi Ku, 1-1,5-7 Yamanote, Sapporo, Hokkaido 0630005, Japan
[2] Natl Hosp Org, Hokkaido Med Ctr, Dept Cardiol, Nishi Ku, Sapporo, Hokkaido, Japan
关键词
Heart injury; penetrating; perforation; shunt; ventricular septum;
D O I
10.1002/ams2.419
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Ventricular septal perforation (VSP) can be caused by a penetrating cardiac injury. Diagnosis of VSP tends to be delayed because a shunt might not be detected by color flow Doppler at an early stage following injury. Case presentation A 60-year-old man with depression was admitted to the emergency center after a knife injury in the chest. A focused assessment with sonography for trauma revealed cardiac tamponade. Shortly after an open cardiac massage and a pericardiotomy, his spontaneous circulation returned. At a later stage, follow-up computed tomography, echocardiography, and left ventriculography showed traumatic ventricular septal perforation. Conservative therapy was chosen because the pulmonary blood flow/systemic blood flow ratio was 1.42. Conclusion The initial contrast computed tomography shows a septal hematoma. Its presence could be perceived as a perforation site in the interventricular septum.
引用
收藏
页码:321 / 324
页数:4
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