Operative Versorgung von Thoraxverletzungen innerhalb der ersten Operationsphase

Liener, U. C.; Sauerland, Stefan; Knöferl, Markus W.; Bärtl, Christoph; Riepl, C.; Kinzl, L.; Gebhard, Florian

doi:10.1007/s00113-005-1048-3

Cited by 20 publications

(8 citation statements)

References 42 publications

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“…Acute traumatic injury of the thoracic aorta is a relatively common injury of deceleration accidents, usually high-speed motor vehicle accidents [3] that still remains highly lethal [1,4]. As a consequence of major car crashes, thoracic aortic ruptures occur in 10 to 30% of multiply injured patients [5].…”

Section: Discussionmentioning

confidence: 99%

“…Only 15% of these patients reach the hospital alive and their management is further complicated by other lesions in the skeletal and visceral organs with significant difficulties in their diagnosis [7]. Frequently, these patients have also multiple other severe injuries [1,8,9] which may draw the main attention of the involved physicians in an Accident and Emergency unit, causing a delay in the diagnosis and treatment of post-traumatic aortic dissections. Early diagnosis of dissection is difficult as it mainly relies on high index of suspicion based on the mechanism of the injury.…”

Section: Discussionmentioning

confidence: 99%

“…Only a very careful study and interpretation of the trauma history and conditions, the clinical presentation and examination and the appropriate radiological investigation will identify all the related injuries [1]. Such interpretation will offer the key to the correct diagnosis and will also dictate the priorities in the treatment strategy.…”

Section: Introductionmentioning

confidence: 99%

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Right procedure, wrong organ, an unusual case report of aortic trauma in a multiple injured patient

Mitsos

Chantler

Konstantinou

et al. 2009

Cases J

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Blunt traumatic injury and acute dissection of thoracic aorta is increasing in incidence in seriously multi-trauma patients, remaining highly lethal. Early identification and repair is the key to a successful outcome. We report an unusual case of a 62-year-old man involved in a motor vehicle accident after subarachnoid hemorrhage due to an intracranial artery aneurysm rupture. The post-traumatic aorta dissection was overlooked during the initial evaluation and was found incidentally later during an attempt for endovascular treatment of the intracranial aneurysm. The pitfalls in the diagnostic approach of this patient are discussed and the paramount importance of the correct interpretation of all the available clinical and investigational findings in multiple injured patients are highlighted.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Right procedure, wrong organ, an unusual case report of aortic trauma in a multiple injured patient

Mitsos

Chantler

Konstantinou

et al. 2009

Cases J

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“…[12] Nevertheless, severe chest injuries are still associated with significant morbidity and mortality. [34]…”

mentioning

confidence: 99%

“…[3] Lesions of the tracheobronchial system and diaphragmatic ruptures should be treated urgently with primary surgical repair. Penetrating chest injuries in hemodynamically unstable patients require emergency operative therapy.…”

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confidence: 99%

Rates of thoracic trauma and mortality due to accidents in Brazil

et al. 2009

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AIM:To report on the causes of trauma, indexes of trauma, and mortality related to thoracic trauma in one region of Brazil.MATERIALS AND METHODS:This prospective study was performed at the Regional Trauma Center in São José do Rio Preto over a 1-year period, from 1st July 2004 to 30th June 2005. We included all patients attending the center's emergency room with thoracic trauma and an anatomic injury scale (AIS) ≥ 2. We collected data using a protocol completed on arrival in hospital utilizing the AIS. We studied the types of accidents as well as the mortality and the AIS scores. Prevalence rates were calculated and the paired t-test and logistic regression were employed for the statistical analysis.RESULTS:There were a total of 373 casualties with AIS ≥ 2 and there were 45 (12%) deaths. The causes of thoracic trauma among the 373 casualties were as follows: 91 (24.4%) car crashes, 75 (20.1%) falls, 46 (12.3%) motorbike accidents, 40 (10.7%) stabbings, 22 (5.9%) accidents involving pedestrians, 21 (5.6%) bicycle accidents, 17 (4.6%) shootings, and 54 (14.5%) other types of accident. The severity of the injuries was classified according to the AIS: 224 (60%) were grade 2, 101 (27%) were grade 3, 27 (7.2%) were grade 4, 18 (4.9%) were grade 5, and 3 were (0.8%) grade 6. With respect to thoracic trauma, pedestrians involved in accidents and victims of shootings had mortality rates that were significantly higher than that of those involved in other types of accidents.CONCLUSION:Road accidents are the main cause of thoracic injury, with accidents involving pedestrians and shootings being associated with a greater death rate.

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Emergency thoracotomies in traumatic cardiac arrests following blunt trauma – experiences from a German level I trauma center

Niemann

Graef

Hahn

et al. 2023

Eur J Trauma Emerg Surg

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Purpose Resuscitative thoracotomies (RT) are the last resort to reduce mortality in patients suffering severe trauma. In recent years, indications for RT have been extended from penetrating to blunt trauma. However, discussions on efficacy are still ongoing, as data on this rarely performed procedure are often scarce. Therefore, this study analyzed RT approaches, intraoperative findings, and clinical outcome measures following RT in patients with cardiac arrest following blunt trauma. Methods All patients admitted to our level I trauma center's emergency room (ER) who underwent RT between 2010 and 2021 were retrospectively analyzed. Retrospective chart reviews were performed for clinical data, laboratory values, injuries observed during RT, and surgical procedures. Additionally, autopsy protocols were assessed to describe injury patterns accurately. Results Fifteen patients were included in this study with a median ISS of 57 (IQR 41–75). The 24-h survival rate was 20%, and the total survival rate was 7%. Three approaches were used to expose the thorax: Anterolateral thoracotomy, clamshell thoracotomy, and sternotomy. A wide variety of injuries were detected, which required complex surgical interventions. These included aortic cross-clamping, myocardial suture repairs, and pulmonary lobe resections. Conclusion Blunt trauma often results in severe injuries in various body regions. Therefore, potential injuries and corresponding surgical interventions must be known when performing RT. However, the chances of survival following RT in traumatic cardiac arrest cases following blunt trauma are small.

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Operative Versorgung von Thoraxverletzungen innerhalb der ersten Operationsphase

Cited by 20 publications

References 42 publications

Right procedure, wrong organ, an unusual case report of aortic trauma in a multiple injured patient

Right procedure, wrong organ, an unusual case report of aortic trauma in a multiple injured patient

Rates of thoracic trauma and mortality due to accidents in Brazil

Emergency thoracotomies in traumatic cardiac arrests following blunt trauma – experiences from a German level I trauma center

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