2007, Number 3
Bilateral thoracotomy for damage control in the shock room. Case report
Ávila PO, Vázquez MJC, Cortés GED, Sánchez LA, Ugalde LJC, Morales FB
Full text
Language: Spanish
References: 8
Page: 206-209
PDF size: 87.66 Kb.
ABSTRACT
A 42 year old male was admitted to the shock-trauma room at The Mexican Red Cross Trauma Center with a gunshot penetrating wound to the thorax; the patient was restless, pale, BP 90/60, heart rate 110, entrance injury at the right 4th intercostal space and anterior axillary line, exit orifice in the left infrascapular region; a right thoracostomy tube was placed but the patient continued to be hemodinamically unstable and deteriorated; in quick succession orotracheal intubation, bilateral saphenostomy and emergency room left thoracotomy with supradiaphragmatic thoracic aorta clamping, pericardiotomy and open cardiac massage were performed, without clinical improvement. Immediately, a right anterolateral thoracotomy was done obtaining 1,500 mL of partially clotted blood; lacerations in the right lower lobe of the lung and diaphragm were identified. The diaphragm was opened and abdominal vena cava and aortic injuries were found. The patient continued bleeding despite compression and arrested shortly afterwards. Hypothetical considerations are made regarding the course of action to be taken if similar cases arrive.REFERENCES