title: A case of deep pulmonary laceration associated with blunt chest trauma treated by emergency room thoracotomy.
abstract: A 30-year-old man fell from the fourth floor of a building and suffered a chest injury. He was transported to our hospital within 50 minutes. Chest roentgenography showed left hemopneumothorax and a shift of the mediastinal shadow to the right. Furthermore, most of the left upper lobe did not appear collapsed, and an infiltrative shadow and light macular shadows were noted. These findings led to a diagnosis of deep pulmonary laceration. The volume of blood in the left drainage tube reached about 1,000 mL within 1 hour. Therefore, we performed emergency room thoracotomy (ERT) and clamped the pulmonary hilum manually. We then moved him to an operating room. Upon surgery, we found extensive laceration of the whole lung, and left pneumonectomy was necessary. He was discharged on hospital day 58. ERT and pulmonary hilum clamping may improve the survival of patients with deep pulmonary laceration and uncontrollable pleural hemorrhage.
authors.affiliation: Department of surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193 Japan. masudar@is.icc.u-tokai.ac.jp
authors.forename: Ryota
authors.initials: R
authors.lastname: Masuda
authors.forename: Tomoki
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hamamoto
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Inoue
authors.forename: Masayuki
authors.initials: M
authors.lastname: Iwazaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inoue
mesh_terms: D000058:Accidental Falls; D000328:Adult; D004636:Emergency Service, Hospital; D006468:Hemopneumothorax / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D022125:Lacerations / Q000175:diagnosis / Q000601:surgery*; D055370:Lung Injury / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D011013:Pneumonectomy / Q000379:methods*; D013908:Thoracotomy; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000601:surgery*