Fatal delayed hemopericardium and hemothorax following blunt chest trauma
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CASE REPORT
Fatal delayed hemopericardium and hemothorax following blunt chest trauma Marek Dokoupil 1,2 & Klára Marecová 3 & Matěj Uvíra 1 & Marek Joukal 4 & Eva Mrázková 2 & Jana Chmelová 5 & Petr Handlos 1 Accepted: 29 November 2018 # Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Cardiac injury following blunt chest trauma is common in motor vehicle accidents due to a crush or blast injury. Severe cardiac trauma is associated with a very high mortality. If a cardiac injury develops several weeks after non-penetrating chest trauma, establishing a causal link between the traumatic event and the cardiac injury becomes complicated. This article reports a case of fatal delayed hemopericardium and hemothorax following a motor vehicle accident including blunt chest trauma 34 days prior to death. The cardiac injury was caused by displacement of a sharp irregular fragment of one of the decedents fractured ribs and the primary defect was sealed by blood clots. Subsequent bleeding occurred when the thrombus was displaced. Since the incidence of blunt high-energy chest injuries is relatively high, heart and large vessel injuries must be taken into account and a comprehensive examination needs to be done in order to prevent the delayed development of fatal complications. Keywords Cardiac injury . Delayed hemopericardium . Delayed hemothorax . Blunt trauma . Stab wound
Introduction Cardiac injury following blunt-chest trauma is quite common. It occurs in motor vehicle accidents following crush or blast injury [1, 2]. Severe cardiac trauma has a very high degree of mortality, with the majority of victims dying at the scene of the accident or on the way to hospital [3]. If the cardiac injury develops after an interval of several weeks following non-penetrating chest trauma, establishing a causal link between the traumatic event and cardiac injury becomes complicated [4]. This article reports a case of fatal delayed hemopericardium and hemothorax following motor
* Petr Handlos [email protected] 1
Department of Forensic Medicine, University Hospital Ostrava, CZ-708 52 Ostrava, Czech Republic
2
Department of Epidemiology and Public Health, Faculty of Medicine, Ostrava University, CZ-703 00 Ostrava, Czech Republic
3
Department of Forensic Medicine and Medical Law, University Hospital Olomouc, CZ-779 00 Olomouc, Czech Republic
4
Department of Anatomy, Faculty of Medicine, Masaryk University, CZ-625 00 Brno, Czech Republic
5
Department of Radiology, Ostrava City Hospital, CZ-728 80 Ostrava, Czech Republic
vehicle accident including blunt chest trauma 34 days prior to death.
Case report We report the case of a 47-year-old woman pedestrian hit by a reversing car at 6mph. In the emergency ward at the hospital the woman reported chest pain at the left side of the chest, her breathing was slightly weakened, and her blood pressure was 220/120 mmHg with a heart rate of 100 beats per minute. The injury manifested as superficial skin trauma with scarring and bruises on the left part of the hea
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