Isolated left atrial rupture following blunt chest trauma

Abstract

Pediatric blunt cardiac rupture (BCR) is uncommon in the pediatric population and is associated with a high mortality rate. Isolated Left atrial chamber rupture following low impact blunt chest trauma is a very rare form of BCR. This report presents a 3 year old boy who presented with hemorrhagic shock and a massive left hemothorax following the fall of a table top on his chest. The patient underwent urgent left antero-lateral thoracotomy, with cardiopulmonary bypass, and the injury was successfully repaired. Based on our literature review, the isolated left atrial rupture after blunt chest trauma is extremely rare. A high level of suspicion should be maintained for early diagnosis and management. The typical findings are hemorrhagic shock with cardiac tamponade or massive hemothorax. The use of cardiac bypass and auto-transfuser can greatly assist in the speed of resuscitation. Further research might help in assessing the benefit in using bypass on survival on this subset of trauma cases.