Isolated tear in left atrial appendage due to blunt trauma chest: A rare case report

Salooja, Manpreet Singh; Singla, Manender Kumar; Srivastava, Anupam; Mukherjee, Kishore C.

doi:10.1016/j.jsha.2012.11.001

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…Since left atrial appendage rupture is caused by a direct external force to the left atrium, the pericardial injury is usually ipsilateral to the left side of the pericardium, resulting in perforation of the left thoracic cavity. Therefore, a massive haemothorax caused by left pericardial injury is almost always a left-sided haemothorax [3] , [4] , [5] , [6] . Left atrial appendage rupture with right-sided haemothorax due to right pericardial injury is uncommon, as in this case.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Left atrial appendage rupture: A rare complication of right-sided haemothorax: A case report

Sugaya¹,

Funakoshi²,

Mizobe³

et al. 2022

Trauma Case Reports

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Section: Discussionmentioning

confidence: 99%

“…Fatal complications of cardiac injury include cardiac tamponade and massive haemothorax due to perforation to the thoracic cavity, which immediately results in cardiac arrest and requires rapid intervention. When left atrial appendage rupture is associated with haemothorax, rupture to the left side is common [3] , [4] , [5] , [6] .…”

Section: Introductionmentioning

confidence: 99%

Left atrial appendage rupture: A rare complication of right-sided haemothorax: A case report

Sugaya¹,

Funakoshi²,

Mizobe³

et al. 2022

Trauma Case Reports

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Blunt Cardiac Rupture: A Diagnostic Challenge

Pinni

Kumar

Dharap

2016

JCDR

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A 22-year-old unidentified male was brought to the emergency room with history of road traffic crash, with no witnesses to the accident. At presentation, patient was agitated, drowsy and diaphoretic with tachycardia of 130/min and Blood Pressure (BP) of 78mmHg systolic. There was bilaterally equal air entry, mild abdominal tenderness and blood tinged urine on inserting Foley catheter.On fluid resuscitation, BP transiently rose and patient became responsive and obeyed commands. BP showed downward trend to 70 mmHg systolic over next ten minutes and Central Venous Pressure (CVP) was found to be 20cm of H 2 O. Heart sounds were muffled on auscultation. Chest radiograph was suggestive of a widened mediastinum [Table/ Fig-1]. Pelvic radiograph was suspicious of pubic diastasis suggestive of open book pelvic fracture. The hospital ultrasound machine was out of order and patient was unstable to be shifted to radiology suite for Focused Assessment by Sonography in Trauma (FAST) or Trans Thoracic Echocardiography (TTE).A primary diagnosis of cardiac tamponade was considered and urgent cardiac surgery consultation was sought. The patient was intubated in view of progressive hypotension. On reassessment, air entry was reduced bilaterally, hence, bilateral intercostal drains were inserted and pneumothorax was drained bilaterally. Subsequently, air entry improved bilaterally. CVP persisted to be 20cm of H 2 O and patient continued to be hypotensive. Blind pericardiocentesis was attempted unsuccessfully. Patient was shifted into the operation theatre and subxiphoid pericardial window revealed a bulging pericardium. Diagnostic Peritoneal Lavage (DPL) was also done which showed haemoperitoneum. Median sternotomy was done and 250ml of clots and blood was evacuated on opening pericardium, following which BP showed an upward trend. A 0.5 cm actively bleeding rent was identified on right atrial appendage [Table /Fig-2]. The rent was closed with 5-0 polypropylene suture in two layers. Laparotomy was done and 600ml haemoperitoneum was evacuated. Splenectomy was done for grade four laceration. Large non-expanding pelvic and retroperitoneal hematoma and a small non-bleeding liver laceration were left untouched. Patient was transfused four units of blood and fresh frozen plasma each. Patient made an uneventful recovery. A postoperative TTE showed no abnormality. Patient also had a tibial spine avulsion fracture Blunt Cardiac Rupture (BCR) is a life threatening injury. Majority of patients do not reach the hospital and in those who reach the emergency department, timely diagnosis and treatment is a challenge. The case is about a patient with multiple blunt injuries who presented in shock. Cardiac tamponade was suspected on clinical grounds and on evidence of mediastinal widening on radiograph. In the absence of songography, the diagnosis was confirmed by subxiphoid pericardial window. Emergency thoracotomy revealed a right atrial appendage rupture which was surgically corrected. The patient also underwent splenectomy for grade IV splenic ...

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Isolated tear in left atrial appendage due to blunt trauma chest: A rare case report

Cited by 2 publications

References 6 publications

Left atrial appendage rupture: A rare complication of right-sided haemothorax: A case report

Left atrial appendage rupture: A rare complication of right-sided haemothorax: A case report

Blunt Cardiac Rupture: A Diagnostic Challenge

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