[Experience of damage control as the primary surgery for thoraco-abdominal injury with hemorrhagic shock].
We experienced a traumatic victim with thoracic and abdominal injury with hemorrhagic shock, who was successfully treated with damage control. Thoracic drainage revealed more than 300 ml/hour of continuous hemorrhage in the left thoracic cavity with 60-80 mmHg of non-responding hypotention. Although we performed emergency partial resection of the injured lung, intraabdominal packing and transcatheter arterial embolization, intrathoracic hemorrhage and hemorrhagic shock was not controlled. We decided re-thoracotomy and performed peri-pulmonary packing around the injured lung, by which we successfully controlled temporary intrathoracic hemorrhage and definitive left lower lobectomy. Peri-pulmonary packing was effective for intrathoracic hemostasis without lethal ventilatory and circulatory complication in this case.
Critical Care and Emergency Medical Center, Yokohama City University Medical Center, Yokohama, Japan.
Yoshihiro
Y
Moriwaki
Makoto
M
Kato
Hiroshi
H
Toyoda
Takayuki
T
Kosuge
Nobuyuki
N
Harunari
Masayuki
M
Iwashita
Yoshio
Y
Tahara
Noriyuki
N
Suzuki
D000007:Abdominal Injuries / Q000628:therapy*; D000063:Accidents, Traffic; D004632:Emergency Medical Services / Q000379:methods*; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D012771:Shock, Hemorrhagic / Q000628:therapy*; D013898:Thoracic Injuries / Q000628:therapy*; D055815:Young Adult