Cardiopulmonary bypass after severe blunt hepatic injury: management of multi-system blunt trauma in an adolescent

Abstract

A 16-year-old adolescent male sustained combined injuries to the tricuspid valve and liver. This injury is exceptional due to the mechanism and the circumstances in which it took place: a flying pumpkin thrown from a sport utility vehicle. An echocardiogram demonstrated a flail chordal apparatus associated with the posterior leaflet of the tricuspid valve, creating substrate for severe tricuspid regurgitation with preserved right heart function. He was treated with non-operative management for the liver injury; he remained hemodynamically stable and was discharged home. He underwent successful repair of the tricuspid valve 17 days following the initial injury necessitating systemic anticoagulation and was discharged home two days later. The patient recovered fully without residual valvular pathology or hepatic sequelae.

A Case of Traumatic Retrograde Type A Aortic Dissection Accompanied by Multiorgan Injuries

“…As Kaplan et al 7 ) reported, delayed hemorrhage generally occurs during the first 72 h. Repair within this period did not seem inevitable for our patient who was stable. However, Tiberio et al 8 ) reported that the median healing time of grade II subcapsular hematomas in the liver was 16 days, and Streit et al 9 ) reported tricuspid valve repair using CPB 17 days after NOM for concomitant blunt hepatic injury. Takahashi et al 10 ) also reported successful repair of an ascending aortic dissection caused by blunt trauma accompanied by multiorgan injuries 10 months after the incident.…”