Transdiaphragmatic repositioning of the heart in the setting of emergency laparotomy after blunt trauma.
Cardiac luxation after blunt trauma is a rare condition that carries a high mortality rate. We report a case of a left pericardial rupture with partial dislocation of the heart into the left pleural cavity and cardiac strangulation in a polytraumatized patient after a severe motor vehicle accident. This case is of special interest because the patient not only had cardiovascular compromise but was also actually in cardiac arrest and being resuscitated when an emergency repositioning of the heart through the diaphragm in the setting of damage control laparotomy restored circulation. This report stresses the need for a high index of suspicion for accurate early diagnosis of pericardial rupture.
Department of Trauma Surgery, Medical University of Graz, 8036 Graz, Austria.
Rainer
R
Gumpert
Sylvia
S
Archan
Veronika
V
Matzi
Freyja-Maria
FM
Smolle-Jüttner
D000063:Accidents, Traffic; D006335:Heart Injuries / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000601:surgery; D010496:Pericardium / Q000293:injuries* / Q000601:surgery; D012421:Rupture / Q000175:diagnosis / Q000601:surgery; D013898:Thoracic Injuries / Q000601:surgery*; D014949:Wounds, Nonpenetrating / Q000601:surgery*