title: Blunt Cardiac Rupture: A Diagnostic Challenge.
abstract: Blunt Cardiac Rupture (BCR) is a life threatening injury. Majority of patients do not reach the hospital and in those who reach the emergency department, timely diagnosis and treatment is a challenge. The case is about a patient with multiple blunt injuries who presented in shock. Cardiac tamponade was suspected on clinical grounds and on evidence of mediastinal widening on radiograph. In the absence of songography, the diagnosis was confirmed by subxiphoid pericardial window. Emergency thoracotomy revealed a right atrial appendage rupture which was surgically corrected. The patient also underwent splenectomy for grade IV splenic injury. Liver injury, pubic diastasis and tibial spine avulsion fracture was managed conservatively. He recovered well. Systematic observance of trauma resuscitation guidelines can help salvage patients with life threatening complex injuries even in the absence of specialized imaging investigations.
authors.affiliation: Post Graduate Resident, Department of General Surgery, Lokmanya Tilak Municipal Medical College and General Hospital , Sion, Mumbai, Maharashtra, India .
authors.forename: Suraj
authors.initials: S
authors.lastname: Pinni
authors.affiliation: Assistant Professor, Department of General Surgery, Lokmanya Tilak Municipal Medical College and General Hospital , Sion, Mumbai, Maharashtra, India .
authors.forename: Vineet
authors.initials: V
authors.lastname: Kumar
authors.affiliation: Professor, Department of General Surgery, Lokmanya Tilak Municipal Medical College and General Hospital , Sion, Mumbai, Maharashtra, India .
authors.forename: Satish Balkrishna
authors.initials: SB
authors.lastname: Dharap
keywords: Cardiac tamponade; Focussed assessment with sonography in trauma; Polytrauma; Right atrial appendage