Chronic non-healing perianal ulcer as presenting sign of acquired immunodeficiency syndrome

Abstract

Introduction: Penetrating cardiac injuries are very rare, an approximate incidence of 0.16% has been described. They have a high mortality rate, most of them die at the site of the accident. PCI should be suspected in any penetrating wound over Ziedler's area. Case report: An 18-year-old male with no known history was taken by paramedics to the emergency department for having suffered a stab wound to the left hemithorax 45 minutes before. On arrival he was in shock (hypotensive, tachycardic, tachypnea, hypoxemic) and beck's triad. Due to the suspicion of cardiac injury, he was admitted to the operating room, where a left anterolateral thoracotomy was performed, identifying a 1 cm wound in the right ventricle, corresponding to AAST grade IV. Vascular control and suture with monofilament was performed, and an endopleural probe was placed at the end. With an adequate postoperative period, the patient was discharged on the fourth day without eventualities. Conclusion: It is important to keep in mind this type of lesion due to its high mortality rate, and immediate action should be taken upon suspicion. This case is an example, where if approached in a timely manner, the prognosis is good despite the high mortality.