Abstract
BackgroundCardiac tamponade due to aortic injury after blunt trauma is a rare and potentially fatal injury. Most aortic injuries caused by blunt trauma present as aortic dissection or rupture of the aortic isthmus. Several cases of delayed aortic injury have been reported. However, all of these injuries were observed in the descending aorta because they had been caused by a posterior rib fracture.Case presentationWe report the first case of cardiac tamponade associated with delayed ascending aortic perforation 2 weeks after blunt trauma. The patient was an 81-year-old man.ConclusionIn cases of blunt chest trauma, delayed ascending aortic injury causing cardiac tamponade is possible associated with various causes such as direct injury by fractured rib or delayed aortic perforation of initial blunt injury.
Highlights
Cardiac tamponade due to aortic injury after blunt trauma is a rare and potentially fatal injury
Most aortic injuries caused by blunt trauma present as aortic dissection or rupture of the aortic isthmus due to indirect forces
We describe a case of cardiac tamponade associated with delayed ascending aortic perforation 2 weeks after blunt trauma
Summary
Cardiac tamponade after blunt trauma is rare and usually associated with rupture of cardiac chambers on the relatively weaker right side [1]. Several cases of delayed aortic injury caused by rib fracture have been reported. A laceration-type wound approximately 7 mm in size with 2 mm perforation (Fig. 2) was found at the level of perforated pericardium (Fig. 1a). To our knowledge, delayed ascending aortic perforation after blunt trauma has not been reported. We describe a case of cardiac tamponade associated with delayed ascending aortic perforation 2 weeks after blunt trauma. Case presentation An 81-year-old man presented to our hospital with chest pain and dyspnea 2 weeks after sustaining blunt trauma from a cultivator accident. At the time of the accident, he did not seek medical care On admission, he was alert and complained of chest pain. A bruise was noted on the anterior chest His blood pressure had decreased to 70/50 mmHg; his other vital signs were normal. We could not find any obvious laceration of the parietal pericardium except for a small
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