Subject(s)
Contusions/therapy , Critical Care/methods , Lung Injury , Physical Therapy Modalities , Respiration, Artificial , Respiratory Distress Syndrome/therapy , Thoracic Injuries/therapy , Combined Modality Therapy , Contusions/classification , Contusions/mortality , Humans , Monitoring, Physiologic , Respiratory Distress Syndrome/classification , Respiratory Distress Syndrome/mortality , Survival Rate , Thoracic Injuries/classification , Thoracic Injuries/mortalityABSTRACT
The number of published cases of adolescents surviving thoracic aortic injuries with accompanying severe thoracic injuries is small. Only 20-30% of all these patients reach the trauma center alive. In the present case we demonstrate the diagnostic, operative and intensive care management in a 15-year-old girl. The exact interpretation of the AP thoracic X-ray in connection with a typical mechanism of injury led to the detection of a haemomediastinum. This is very important in the further development of diagnostics, because the conventional X-ray picture does not show significant signs in the case of an incomplete aortic rupture. Diagnostic hints have to be derived from the detection of the haemomediastinum. The girl was operated on under left heart bypass. Spinal ischaemia was absent after surgery, and renal failure also did not occur. The adjacent severe lung confusion healed under kinetic therapy with a kinetic treatment table without pulmonary complications.