[Blunt trauma with bullet-proof vests. Skin lesions are no reliable predictor of injury severity].
It is well known that so-called bullet-proof vests offer protection against a wide range of penetrating trauma, but their protection against blunt trauma is less well understood. Fast projectiles may result in hematomas and contusions behind the armour. We report a traffic accident involving a young soldier wearing a ballistic protection vest resulting in a right thoracoabdominal blunt trauma leading to a confined liver compression rupture. As nearly no skin marks were detectable, we point out that every emergency department surgeon should be very suspicious if a patient wore a ballistic vest at the time of the accident--there may be no skin marks despite severe intra-abdominal trauma. Our patient recovered following hypotensive ICU treatment, thrombocyte mobilization, and factor VIIa substitution.
Feld Hospital Mazaar e Sharif, Afghanistan mit der Abteilung für Chirurgie, Mazaar e Sharif, Afghanistan. ddoll@gmx.de
D
D
Doll
B
B
Illert
S
S
Bohrer
C
C
Richter
C
C
Woelfl
D000007:Abdominal Injuries / Q000175:diagnosis* / Q000628:therapy; D000063:Accidents, Traffic; D055826:Afghan Campaign 2001-; D003422:Critical Care; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D006801:Humans; D015601:Injury Severity Score; D008099:Liver / Q000293:injuries; D008297:Male; D008889:Military Personnel; D011481:Protective Clothing; D012421:Rupture; D012867:Skin / Q000293:injuries*; D013898:Thoracic Injuries / Q000175:diagnosis* / Q000628:therapy; D013921:Thrombocytopenia / Q000175:diagnosis / Q000628:therapy; D036542:Tomography, Spiral Computed; D014463:Ultrasonography; D014948:Wounds, Gunshot / Q000175:diagnosis* / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000601:surgery; D055815:Young Adult
Stumpfes Körperstammtrauma mit ballistischer Schutzweste. Prellmarken geben keine zuverlässigen Hinweise auf innere Verletzungen.