Sternal fractures and delayed cardiac tamponade due to a severe blunt chest trauma Huai-min Liang, Qiu-lin Chen, Er-yong Zhang, Jia Hu
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.075
The American Journal of Emergency Medicine , Vol. 34 , Issue 4 ,
Published online: July 29 2015
x Sternal fractures caused by blunt chest trauma are associated with an increased incidence of cardiac injury. Reports of the incidence of cardiac injury associated with sternal fracture range from 18% to 62% [1]. Delayed cardiac tamponade is a rare phenomenon that appears days or weeks after injury. Moreover, after nonpenetrating chest trauma, cardiac tamponade is very rare and occurs in less than 1 of 1000 [2]. This case describes a patient who had delayed cardiac tamponade 17 days after a severe blunt chest trauma.
Dual-source computed tomography may define cardiac contusion in patients with blunt chest trauma in ED Mucahit Emet, Murat Saritemur, Bayram Altuntas, Leyla Karaca, Fatih Mehmet Sari, Yasin Bilgin, Mecit Kantarci, Sahin Aslan
DOI: http://dx.doi.org/10.1016/j.ajem.2014.12.059
The American Journal of Emergency Medicine , Vol. 33 , Issue 6 ,
Published online: December 31 2014
x We report a 20-year-old woman with blunt chest trauma because of a motor vehicle injury who has traumatic asphyxia and hypotension. The diagnosis of blunt cardiac injury was put by using dual-energy computed tomography in the emergency department because other laboratory and imaging modalities were useless. After hospitalization in intensive care unit, she was treated with supportive and antiedema therapy. The patient was extubated on the fifth day and discharged on the ninth day without any sequel.
A pig model for blunt chest trauma: no pulmonary edema in the early phase David Couret, Sophie de Bourmont, Nicolas Prat, Pierre-Yves Cordier, Jean-Baptiste Soureau, Dominique Lambert, Bertrand Prunet, Pierre Michelet
DOI: http://dx.doi.org/10.1016/j.ajem.2013.05.028
The American Journal of Emergency Medicine , Vol. 31 , Issue 8 ,
Published online: June 27 2013
x Chest trauma remains a leading cause of trauma-death. Since lung contusion is one of the most important lesions implicated, the aim of this experimental study was to evaluate the cardiorespiratory consequences of an isolated lung contusion model.
Delayed massive hemothorax complicating simple rib fracture associated with diaphragmatic injury Chin-Li Chen, Yeung-Leung Cheng
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.060
The American Journal of Emergency Medicine , Vol. 32 , Issue 7 ,
Published online: January 9 2014
x Traumatic hemothorax is potentially life threatening. Rib fractures are the commonest injury after chest trauma, which accounts for 10% of patients after trauma. A delayed massive hemothorax after simple rib fracture is rare. The possibility of delayed sequelae after chest trauma should be considered, and patients should be informed of this possibility. We present a case of this uncommon situation with delayed massive hemothorax caused by simple fracture of the lower ribs. Admission should be considered for close observation when presenting with fracture of the lower ribs because of the possibility of diaphragmatic injury or intra-abdominal injury, even if a simple rib fracture is found initially.
Right coronary artery dissection and aneurysm presented as acute inferior myocardial infarction from an automobile airbag trauma Chunlai Zeng, Wuming Hu, Ning Zhu, Xuyong Zhao, Jian Xu, Shiyong Ye, Yijia Xiang, Linchun Lv
DOI: http://dx.doi.org/10.1016/j.ajem.2015.07.074
The American Journal of Emergency Medicine , Vol. 33 , Issue 10 ,
Published online: July 29 2015
x Coronary artery dissection and aneurysm culminating in acute myocardial infarction are rare after blunt chest trauma. We are reporting a case of a previously healthy 52-year-old man who presented with right inferior lobe contusion, pleural effusion, right interlobar fissure effusion, bone fracture of right fourth rib, and acute inferior wall myocardial infarction and who experienced blunt trauma in his right chest wall by an airbag deployment in a car accident. Coronary angiography showed an aneurysm in the middle of right coronary artery with 70% afferent narrowing just distal to the aneurysm with no visible atherosclerotic lesion.
Late traumatic aortic dissection Manolis S. Kallistratos, Antonios N. Pavlidis, Athanasios S. Tsoukas, Dimitrios Mauropoulos, Ioannis P. Levantakis, Graeme Hesketh, Athanasios J. Manolis
DOI: http://dx.doi.org/10.1016/j.ajem.2011.07.001
The American Journal of Emergency Medicine , Vol. 30 , Issue 7 ,
Published online: September 12 2011
x Traumatic dissection of the aorta is a well-documented entity with poor prognosis and broad spectrum of clinical presentations. We report a rare case of an asymptomatic late presentation of aortic dissection after a high-speed vehicle accident. This case highlights the importance of high clinical suspicion for the diagnosis of aortic dissection.
Subject Index
DOI: http://dx.doi.org/10.1016/S0735-6757(15)00997-3
The American Journal of Emergency Medicine , Vol. 33 , Issue 12 ,
Published in issue: December 2015
Traumatic mediastinal hematoma: a potentially fatal condition that may be overlooked by traditional Focused Assessment with Sonography for Trauma Li-wen Hsu, Chee-Fah Chong, Tzong-Luen Wang, Bor-hen Wu
DOI: http://dx.doi.org/10.1016/j.ajem.2012.03.022
The American Journal of Emergency Medicine , Vol. 31 , Issue 1 ,
Published online: May 25 2012
x Mediastinal hematoma is an uncommon finding in blunt chest trauma. It may be caused by aortic injury, by mediastinal vascular injury such as aortic injury, and by fractures of the sternum and vertebral column. A huge mediastinal hematoma can result in extrapericardial cardiac tamponade by compressing the adjacent organs. Although Focused Assessment with Sonography for Trauma (FAST) can reliably assess the presence of pericardial effusion in the subxiphoid view, it may overlook mediastinal hematoma.
Life-threatening hemothorax due to azygos vein rupture after chest compression during cardiopulmonary resuscitation Euiseok Yang, WonJoon Jeong, JunWan Lee, SeungWhan Kim
DOI: http://dx.doi.org/10.1016/j.ajem.2014.04.019
The American Journal of Emergency Medicine , Vol. 32 , Issue 11 ,
Published online: April 18 2014
x Hemothorax is not an uncommon cardiopulmonary resuscitation (CPR)–related complication. But hemothorax related to azygos vein injury (AVI) is a rare condition following blunt chest trauma, with no report of CPR-related AVI in the literature. We present a case of azygos vein rupture in a middle-aged woman after repeated chest compression during 1 hour of CPR. She eventually presented with massive hemothorax due to azygos vein rupture diagnosed by computed tomography (CT). When faced with a patient with massive hemothorax after chest compression, azygos vein rupture should be considered as a complication.
What is the clinical significance of chest CT when the chest x-ray result is normal in patients with blunt trauma? Bory Kea, Ruwan Gamarallage, Hemamalini Vairamuthu,, Jonathan Fortman, Kevin Lunney, Gregory W. Hendey, Robert M. Rodriguez
DOI: http://dx.doi.org/10.1016/j.ajem.2013.04.021
The American Journal of Emergency Medicine , Vol. 31 , Issue 8 ,
Published online: June 24 2013
x Computed tomography (CT) has been shown to detect more injuries than plain radiography in patients with blunt trauma, but it is unclear whether these injuries are clinically significant.
Coronary artery dissection after blunt trauma without abnormal electrocardiogram findings Yutaka Kawakami, Ryota Inokuchi, Masahiro Tanji, Fumihito Ito, Yoshibumi Kumada, Shinji Matsuse, Naoki Yahagi, Kazuaki Shinohara
DOI: http://dx.doi.org/10.1016/j.ajem.2014.02.046
The American Journal of Emergency Medicine , Vol. 32 , Issue 9 ,
Published online: March 7 2014
x Coronary artery dissection after blunt trauma has rarely been reported, and all cases reported thus far have shown abnormal electrocardiogram (ECG) findings. We report a case of left main coronary artery dissection in the absence of abnormal ECG findings. This case suggests that coronary artery dissections should be considered in post–blunt trauma cases, even if patients present no laterality of blood pressure or present with normal findings on ECG and chest radiographs. In addition, physicians should follow up these patients closely before surgery.
Isolated sternum fracture with no direct trauma Selcuk Coskun, Altug Hasanbasoglu, Mehmet Dakak, Pınar Koksal Coskun
DOI: http://dx.doi.org/10.1016/j.ajem.2012.09.008
The American Journal of Emergency Medicine , Vol. 31 , Issue 3 ,
Published online: November 1 2012
x Isolated fractures of the sternum are a rare injury, except in the case of iatrogenic ones. Up to 8% of the patients admitted with blunt chest trauma have sternal fractures caused primarily by anterior blunt chest trauma. Sternal fractures are usually caused by motor vehicle accidents due to the chest striking the steering wheel. Almost all sternal fractures are due to direct trauma. Stress or indirect fractures of the sternum are a rare injury. Stress fractures can occur rarely in young athletes from repeated stress and sometimes in elderly patients with osteoporotic bones or other pathological conditions.
Use of extracorporeal membrane oxygenation in severe traumatic lung injury with respiratory failure Shih-Chi Wu, William Tzu-Liang Chen, Hui-Han Lin, Chih-Yuan Fu, Yu-Chun Wang, Hung-Chieh Lo, Han-Tsung Cheng, Chia-Wei Tzeng
DOI: http://dx.doi.org/10.1016/j.ajem.2015.02.007
The American Journal of Emergency Medicine , Vol. 33 , Issue 5 ,
Published online: February 7 2015
x The use of extracorporeal membrane oxygenation (ECMO) in managing acute respiratory distress syndrome had been accepted. Severe lung injury with respiratory failure is often encountered in trauma patients. We report our experience with the use of ECMO in severe traumatic lung injury.
Tracheal diverticulum masquerading as pneumomediastinum in a trauma victim Diane L. Gorgas, Brian Miller
DOI: http://dx.doi.org/10.1016/j.ajem.2014.08.014
The American Journal of Emergency Medicine , Vol. 33 , Issue 2 ,
Published online: August 7 2014
x Background: The differential diagnosis for a paratracheal air collection includes Zenker diverticulum, tracheal diverticulum, apical herniation of the lung, and pneumomediastinum. In the setting of trauma, pneumomediastinum is traditionally regarded as an alarm sign that warrants investigation for tracheal or esophageal rupture, both highly morbid conditions.
Contents
DOI: http://dx.doi.org/10.1016/S0735-6757(13)00426-9
The American Journal of Emergency Medicine , Vol. 31 , Issue 8 ,
Published in issue: August 2013
Supine chest compression: alternative to prone ventilation in acute respiratory distress syndrome Sukhen Samanta, Sujay Samanta, Kapil Dev Soni
DOI: http://dx.doi.org/10.1016/j.ajem.2013.11.014
The American Journal of Emergency Medicine , Vol. 32 , Issue 5 ,
Published online: November 18 2013
x Prone ventilation is usually used for severe acute respiratory distress syndrome. We applied an alternative method to prone position. We described 2 cases of trauma where prone position could not be done. Chest wall compression was performed by 2-kg weight in front of the chest wall bilaterally while the patient was in a supine position. Respiratory mechanics work to improve oxygenation almost as same as the mechanism proposed for prone position without any major adverse effects and serious complications.
Acoustic cardiography S3 detection use in problematic subgroups and B-type natriuretic peptide “gray zone”: secondary results from the Heart failure and Audicor technology for Rapid Diagnosis and Initial Treatment Multinational Investigation Alan S. Maisel, W. Frank Peacock, Kevin S. Shah, Paul Clopton, Deborah Diercks, Brian Hiestand, Michael C. Kontos, Christian Mueller, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2010.03.032
The American Journal of Emergency Medicine , Vol. 29 , Issue 8 ,
Published online: July 14 2010
x Dyspneic emergency department (ED) patients present a diagnostic dilemma. The S3, although highly specific for acute heart failure (AHF) and predicting death and readmission, is often difficult to auscultate. The HEart failure and Audicor technology for Rapid Diagnosis and Initial Treatment (HEARD-IT) multinational trial evaluated the S3 via acoustic cardiography (Audicor). Our goal in this secondary analysis was to determine if the strength of the S3 can provide diagnostic/prognostic information in problematic heart failure subgroups.
Acute myocardial infarction and multiple traumas: a dilemma of protocol Loïc Chimot, Lionel Leroux, Nicolas Morel
DOI: http://dx.doi.org/10.1016/j.ajem.2010.12.005
The American Journal of Emergency Medicine , Vol. 30 , Issue 1 ,
Published online: February 4 2011
x Treatment of myocardial infarction is today governed by specific protocols. Angioplasty involves a therapeutical anticoagulation to prevent the risk of acute thrombosis. Acute myocardial infarction after a blunt trauma has been described, but there is no specific treatment recommendations extant, particularly weighing the risk of hemorrhage. In this report, we describe an adolescent boy who suffered from an acute myocardial infarction by dissection of the left anterior descending coronary after a car crash.
Multiple trauma, resuscitation, and 15 minutes of esophageal intubation: survival without neurologic deficit Philipp Stein, Roland Albrecht, Donat R. Spahn
DOI: http://dx.doi.org/10.1016/j.ajem.2014.01.050
The American Journal of Emergency Medicine , Vol. 32 , Issue 8 ,
Published online: February 6 2014
x Resuscitation of a patient with multiple trauma in pulseless electric activity has a poor outcome. Not only hypovolemia but also hypoxia can lead to cardiac arrest in this population. We report a case that is important for all resuscitation providers. On the one hand, it presents an intriguing chronology with severe trauma, 15 minutes of esophageal intubation, and hypoxic cardiopulmonary resuscitation followed by an astonishing outcome of the patient; on the other hand, it shows how the resuscitation algorithms can save lives in complex circumstances.
Table of Contents
DOI: http://dx.doi.org/10.1016/S0735-6757(16)00142-X
The American Journal of Emergency Medicine , Vol. 34 , Issue 4 ,
Published in issue: April 2016
