Rupture of the Interventricular
Septum after the Blunt Trauma of Thorax
Šmejkal K., Pařízková R.*, Harrer J.**, Lukeš A.***, Koudelka J.****, Žvák I.
Katedra válečné chirurgie, Fakulta vojenského zdravotnictví UO, Hradec Králové, vedoucí katedry: doc. MUDr. A. Ferko, CSc. Chirurgická klinika, Fakultní nemocnice Hradec Králové, přednosta: doc. MUDr. A. Ferko, CSc. *Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice Hradec Králové, přednosta: doc. MUDr. V. Černý, Ph.D., FCCM **Kardiochirurgická klinika, Fakultní nemocnice Hradec Králové, přednosta: doc. MUDr. J. Harrer, CSc. ***Dětská klinika, Fakultní nemocnice Hradec Králové, přednosta: doc. MUDr. E. Pařízková, CSc. ****Oddělení dětské chirurgie a traumatologie, Fakultní nemocnice Hradec Králové, primář: MUDr. J. Koudelka, Ph.D. |
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Summary:
Authors present the case of little patient with the dissection, pseudoaneurysm and finally a rupture of the interventricular septum after
the blunt thracic injury. The patient was smitten as a pedestrian by a car and during the whole period of her stay in the hospital she was
showing signs of circulatory instability. Due to the current intraabdominal injuries this circulatory decompensation was first assigned to
hemoperitoneum, for which the girl was operated on about 3 hours after admission. Nevertheless, even after the abdminal cavity check,
after the treatment of supreficial liver lacerations and intensive volume resuscitation the patient showed signs of insufficiency. Diagnosis
was finally determined on the base of the transthoracic echocardiography (TTE), which proved the traumatic rupture of interventricular
septum. The operation followed correcting the defect, which was performed with a good result according to the TTE postoperatively.
Nevertheless, 27 hours after the admission the patient died due to the electromechanical dissociation. In the discussion the authors then
evoke a number of papers concerning the same topic.
Key words:
blunt thoracic injury – interventricular septal rupture
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