Chest Wall Reconstruction for the Treatment of Lung Herniation and Respiratory Failure 1 Month after Emergency Thoracotomy in a Patient with Traumatic Flail Chest
We report a case of delayed chest wall reconstruction after thoracotomy. A 53-year-old female, a victim of a motor vehicle accident, presented with bilateral multiple rib fractures with flail motion and multiple extrathoracic injuries. Whole-body computed tomography revealed multiple fractures of th...
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| Language: | English |
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Korean Society of Traumatology
2021-12-01
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| Series: | Journal of Trauma and Injury |
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| Online Access: | http://jtraumainj.org/upload/pdf/jti-2020-0059.pdf |
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| author | Junepill Seok Il Jae Wang |
| author_facet | Junepill Seok Il Jae Wang |
| author_sort | Junepill Seok |
| collection | DOAJ |
| description | We report a case of delayed chest wall reconstruction after thoracotomy. A 53-year-old female, a victim of a motor vehicle accident, presented with bilateral multiple rib fractures with flail motion and multiple extrathoracic injuries. Whole-body computed tomography revealed multiple fractures of the bilateral ribs, clavicle, and scapula, and bilateral hemopneumothorax with severe lung contusions. Active hemorrhage was also found in the anterior pelvis, which was treated by angioembolization. The patient was transferred to the surgical intensive care unit for follow-up. We planned to perform surgical stabilization of rib fractures (SSRF) because her lung condition did not seem favorable for general anesthesia. Within a few hours, however, massive hemorrhage (presumably due to coagulopathy) drained through the thoracic drainage catheter. We performed an exploratory thoracotomy in the operating room. We initially planned to perform exploratory thoracotomy and “on the way out” SSRF. In the operating room, the hemorrhage was controlled; however, her condition deteriorated and SSRF could not be completed. SSRF was completed after about a month owing to other medical conditions, and the patient was weaned successfully. |
| format | Article |
| id | doaj-art-cb660189f320443b9830380936d1f591 |
| institution | Kabale University |
| issn | 2799-4317 2287-1683 |
| language | English |
| publishDate | 2021-12-01 |
| publisher | Korean Society of Traumatology |
| record_format | Article |
| series | Journal of Trauma and Injury |
| spelling | doaj-art-cb660189f320443b9830380936d1f5912025-01-16T04:50:50ZengKorean Society of TraumatologyJournal of Trauma and Injury2799-43172287-16832021-12-0134428428710.20408/jti.2020.00591082Chest Wall Reconstruction for the Treatment of Lung Herniation and Respiratory Failure 1 Month after Emergency Thoracotomy in a Patient with Traumatic Flail ChestJunepill Seok0Il Jae Wang1 Department of Cardiovascular and Thoracic Surgery, Chungbuk National University Hospital, Cheongju, Korea Department of Emergency Medicine, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, KoreaWe report a case of delayed chest wall reconstruction after thoracotomy. A 53-year-old female, a victim of a motor vehicle accident, presented with bilateral multiple rib fractures with flail motion and multiple extrathoracic injuries. Whole-body computed tomography revealed multiple fractures of the bilateral ribs, clavicle, and scapula, and bilateral hemopneumothorax with severe lung contusions. Active hemorrhage was also found in the anterior pelvis, which was treated by angioembolization. The patient was transferred to the surgical intensive care unit for follow-up. We planned to perform surgical stabilization of rib fractures (SSRF) because her lung condition did not seem favorable for general anesthesia. Within a few hours, however, massive hemorrhage (presumably due to coagulopathy) drained through the thoracic drainage catheter. We performed an exploratory thoracotomy in the operating room. We initially planned to perform exploratory thoracotomy and “on the way out” SSRF. In the operating room, the hemorrhage was controlled; however, her condition deteriorated and SSRF could not be completed. SSRF was completed after about a month owing to other medical conditions, and the patient was weaned successfully.http://jtraumainj.org/upload/pdf/jti-2020-0059.pdfflail chesthyperbilirubinemiarespiratory insufficiencythoracotomy |
| spellingShingle | Junepill Seok Il Jae Wang Chest Wall Reconstruction for the Treatment of Lung Herniation and Respiratory Failure 1 Month after Emergency Thoracotomy in a Patient with Traumatic Flail Chest Journal of Trauma and Injury flail chest hyperbilirubinemia respiratory insufficiency thoracotomy |
| title | Chest Wall Reconstruction for the Treatment of Lung Herniation and Respiratory Failure 1 Month after Emergency Thoracotomy in a Patient with Traumatic Flail Chest |
| title_full | Chest Wall Reconstruction for the Treatment of Lung Herniation and Respiratory Failure 1 Month after Emergency Thoracotomy in a Patient with Traumatic Flail Chest |
| title_fullStr | Chest Wall Reconstruction for the Treatment of Lung Herniation and Respiratory Failure 1 Month after Emergency Thoracotomy in a Patient with Traumatic Flail Chest |
| title_full_unstemmed | Chest Wall Reconstruction for the Treatment of Lung Herniation and Respiratory Failure 1 Month after Emergency Thoracotomy in a Patient with Traumatic Flail Chest |
| title_short | Chest Wall Reconstruction for the Treatment of Lung Herniation and Respiratory Failure 1 Month after Emergency Thoracotomy in a Patient with Traumatic Flail Chest |
| title_sort | chest wall reconstruction for the treatment of lung herniation and respiratory failure 1 month after emergency thoracotomy in a patient with traumatic flail chest |
| topic | flail chest hyperbilirubinemia respiratory insufficiency thoracotomy |
| url | http://jtraumainj.org/upload/pdf/jti-2020-0059.pdf |
| work_keys_str_mv | AT junepillseok chestwallreconstructionforthetreatmentoflungherniationandrespiratoryfailure1monthafteremergencythoracotomyinapatientwithtraumaticflailchest AT iljaewang chestwallreconstructionforthetreatmentoflungherniationandrespiratoryfailure1monthafteremergencythoracotomyinapatientwithtraumaticflailchest |