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2017, vol. 74, iss. 8, pp. 786-790
Flail chest in a polytraumatized patient: Management and treatment: Case report
aClinical Center Kragujevac, Clinic for General and Thoracic Surgery + University of Kragujevac, Faculty of Medical Sciences
bClinical Center Kragujevac, Clinic for General and Thoracic Surgery
cMilitary Medical Academy, Clinic for Thoracic Surgery, Belgrade
Application of biomedical engineering for preclinical and clinical practice (MESTD - 41007)

Introduction. Management of a polytraumatized patient is a problem that requires a multidisciplinary approach, in order to optimise patient’s outcome. The purpose of this study was to show the approach in the treatment of a patient with a severe life-threatening polytrauma, including a personalized healthcare approach with the positive outcome after the inadequate initial treatment. Case report. We presented a case of a young polytraumatized patient with trauma as a result of road traffic accident. The patient had chest, abdominal and right arm injuries. He was diagnosed of hepatic rupture with conquasation and retroperitoneal hematoma and the patient underwent liver tamponade. Chest trauma due to bilateral serial rib fracture with flail chest was treated by chest drainage. After the adequate multidisciplinary interventions for the patient, the patient was discharged. Conclusion. This case report is of great importance since it shows that severe polytraumatized patients with bad initial prognosis can successfully receive a lifesaving treatment.
Agle, S.C., Kao, L.S., Moore, F.A., Gonzalez, E.A., Vercruysse, G.A., Todd, S.R. (2006) Early predictors of prolonged mechanical ventilation in major torso trauma patients who require resuscitation. American Journal of Surgery, 192(6): 822
Ahmed, Z., Mohyuddin, Z. (1995) Management of flail chest injury: Internal fixation versus endotracheal intubation and ventilation. Journal of Thoracic and Cardiovascular Surgery, 110(6): 1676-1680
American College of Surgeon - Committee on Trauma (2010), 2015 Jun 15
Bergeron, E., Lavoie, A., Clas, D., Moore, L., Ratte, S., Tetreault, S., Lemaire, J., Martin, M. (2003) Elderly Trauma Patients with Rib Fractures Are at Greater Risk of Death and Pneumonia. Journal of Trauma: Injury, Infection, and Critical Care, 54(3): 478-485
Blackbourne, L.H. (2008) Combat damage control surgery. Critical Care Medicine, 36(Suppl): S304-S310
Carmont, M.R. (2005) The Advanced Trauma Life Support course: a history of its development and review of related literature. Postgraduate Medical Journal, 81(952): 87-91
Caruso, D.M., Battistella, F.D., Owings, J.T., Lee, S.L., Samaco, R.C. (1999) Perihepatic packing of major liver injuries: Complications and mortality. Arch Surg, 134(9): 958-62; di
Cirocchi, R., Abraha, I., Montedori, A., Farinella, E., Bonacini, I., Tagliabue, L., i dr. (2010) Damage control surgery for abdominal trauma. Cochrane Database Syst Rev, 1, CD007438
Doklestić, K., Stefanović, B., Gregorić, P., Ivančević, N., Lončar, Z., Jovanović, B., Bumbaširević, V., Jeremić, V., Vujadinović, S.T., Stefanović, B., Milić, N., Karamarković, A. (2015) Surgical management of AAST grades III-V hepatic trauma by Damage control surgery with perihepatic packing and Definitive hepatic repair-single centre experience. World Journal of Emergency Surgery, 10(1): 34
Engel, C., Krieg, J.C., Madey, S.M., Long, W.B., Bottlang, M. (2005) Operative Chest Wall Fixation with Osteosynthesis Plates. Journal of Trauma: Injury, Infection, and Critical Care, 58(1): 181-186
Federle, M.P., Goldberg, H.I., Kaiser, J.A., Moss, A.A., Jeffrey, R.B., Mall, J.C. (1981) Evaluation of abdominal trauma by computed tomography. Radiology, 138(3): 637-644
Gabram, S.G. A., Schwartz, R.J., Jacobs, L.M., Lawrence, D., Murphy, M.A., Morrow, J.S., Hopkins, J.S., Knauft, R. F. (1995) Clinical management of blunt trauma patients with unilateral rib fractures: A randomized trial. World Journal of Surgery, 19(3): 388-393
Gaynor, E.B., Greenberg, S.B. (1985) Untoward sequelae of prolonged intubation. Laryngoscope, 95(12): 1461-1467
Granetzny, A., El-Aal, A.M., Emam, E., Shalaby, A., Boseila, A. (2005) Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary status. Interact Cardiovasc Thorac Surg, 4(6); 583-7
Johnson, S.B., Kearney, P.A., Barker, D.E. (1992) Early criteria predictive of prolonged mechanical ventilation. Journal of Trauma: Injury, Infection, and Critical Care, 33(1): 95-100
Kearney, P.A. (1989) Computed Tomography and Diagnostic Peritoneal Lavage in Blunt Abdominal Trauma. Archives of Surgery, 124(3): 344
Kish, G., Kozloff, L., Joseph, W.L., Adkins, P.C. (1976) Indications for Early Thoracotomy in the Management of Chest Trauma. Annals of Thoracic Surgery, 22(1): 23-28
Kortbeek, J.B., Turki, A.S.A., Ali, J., Antoine, J.A., Bouillon, B., Brasel, K., i dr. (2008) Advanced trauma life support, the evidence for change. J Trauma, 64(6); 1638-50; 8th edition
Lafferty, P.M., Anavian, J., Will, R.E., Cole, P.A. (2011) Operative Treatment of Chest Wall Injuries: Indications, Technique, and Outcomes. Journal of Bone and Joint Surgery-American Volume, 93(1): 97-110
Lee, J.C., Peitzman, A.B. (2006) Damage-control laparotomy. Current Opinion in Critical Care, 12(4): 346-350
Liu, M., Lee, C., Peng, F. (1993) Prospective comparison of diagnostic peritoneal lavage, computed tomographic scanning, and ultrasonography for the diagnosis of blunt abdominal trauma. Journal of Trauma: Injury, Infection, and Critical Care, 35(2): 267-270
Nirula, R., Allen, B., Layman, R., Falimirski, M.E., Somberg, L.B. (2006) Rib fracture stabilization in patients sustaining blunt chest injury. Am Surg, 72(4); 307-9
Nirula, R., Diaz, J.J., Trunkey, D.D., Mayberry, J.C. (2009) Rib Fracture Repair: Indications, Technical Issues, and Future Directions. World Journal of Surgery, 33(1): 14-22
Park, S. (2012) Clinical Analysis for the Correlation of Intra-abdominal Organ Injury in the Patients with Rib Fracture. Korean Journal of Thoracic and Cardiovascular Surgery, 45(4): 246-250
Rodriguez, J.L., Steinberg, S.M., Luchetti, F.A., Gibbons, K.J., Taheri, P.A., Flint, L.M. (1990) Early tracheostomy for primary airway management in the surgical critical care setting. Surgery, 108(4); 655-9
Shorr, R.M., Crittenden, M., Indeck, M., Hartunian, S.L., Rodriguez, A. (1987) Blunt Thoracic Trauma Analysis of 515 Patients. Annals of Surgery, 206(2): 200-205
Simon, B., Ebert, J., Bokhari, F., Capella, J., Emhoff, T., Hayward, T., Rodriguez, A., Smith, L. (2012) Management of pulmonary contusion and flail chest. Journal of Trauma and Acute Care Surgery, 73: S351-S361
Tanaka, H., Yukioka, T., Yamaguti, Y., Shimizu, S., Goto, H., Matsuda, H., Shimazaki, S. (2002) Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. J Trauma, 52(4): 727-32; discussion 732


article language: English
document type: Case Report
DOI: 10.2298/VSP151207097M
published in SCIndeks: 04/08/2017
peer review method: double-blind
Creative Commons License 4.0

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