Reliability Of Clinical Findings And Diagnostic Methods in Potential Penetrating Cardiac Injuries

Yıl 2009, Cilt: 6 Sayı: 1, 22 - 26, 01.04.2009

Mustafa Goz Omer Cakir

Öz

Reliability Of Clinical Findings And Diagnostic Methods in Potential Penetrating Cardiac Injuries

Öz

Objective: Penetrating cardiac injuries are fatal thoracic traumas. Many patients arrive at the hospital dead or in severe shock. Rapid hemodynamic deterioration may develop in patients exposed to cardiac trauma. Early diagnosis and rapid surgical intervention can determine the prognosis. The aim of this study was to analyze retrospectively false cases recognized postoperatively. Methods: Thirteen false positive or negative cases detected as a result of the surgical intervention findings in our department were analyzed retrospectively. Demographic characteristics, causes of injury, time of arrival at the hospital, and emergency room examination findings, as well as the performance of the diagnostic methods used to demonstrate cardiac injury were evaluated. Results: The male to female ratio in the 13 patients was 12:1, and the mean age was 26.30± 12.83 years range 656 years . False positive or false negative cases constituted 22.41% of all potential penetrating cardiac injury cases operated on in our department. The hospital mortality rate was 15.4% 2 patients . Conclusions: Early diagnosis and emergency thoracotomy are essential for the survival of patients after cardiac injury. There are no specific diagnostic methods to guide the diagnosis of potential penetrating cardiac injuries. Therefore, we think that all patients need to be assessed on an individual basis and patient-specific diagnostic strategies should be formulated accordingly

Anahtar Kelimeler

Cardiac Injury, Emergency Room Thoracotomy, Echocardiography, Computed Thorax Tomography

Kaynakça

• 1- Campbell NC, Thomson SR, Muckart DJ, Meumann CM, Van Middelkoop I, Botha JB. Review of 1198 cases of penetrating cardiac trauma. Br J Surg. 1997;84(12):1737-40.
• 2- Gao JM, Gao YH, Wei GB, Liu GL, Tian XY, Hu P, Li CH. Penetrating cardiac wounds: principles for surgical management. World J Surg. 2004;28(10):1025-9. Epub 2004 Sep 29.
• 3- Rozycki GS, Feliciano DV, Ochsner MG, Knudson MM, Hoyt DB, Davis F, Hammerman D, Figueredo V, Harviel JD, Han DC, Schmidt JA. The role of ultrasound in patients with possible penetrating cardiac wounds: a prospective multicenter study. J Trauma. 1999;46(4):543-51; discussion 551-2.
• 4- Takagi H, Mori Y, Murase K, Hirose H.Nail gun penetrating cardiac injury. Eur J Cardiothorac Surg. 2003;23(5):841.
• 5- DeCou CM, Abrams RS, Miller RS, Touloukian RJ, Gauderer MWL. Life-threatening air rifle injuries to the heart in three boys. J Ped. Surg. 2000;35(5):785-787
• 6- Tayal VS, Beatty MA, Marx JA, Tomaszewski CA, Thomason MH. FAST (focused assessment with sonography in trauma) accurate for cardiac and intraperitoneal injury in penetrating anterior chest trauma. J Ultrasound Med. 2004;23(4):467- 72.
• 7- Nagy KK, Gilkey SH, Roberts RR, Fildes JJ, Barrett J. Computed tomography screens stable patients at risk for penetrating cardiac injury. Acad Emerg Med. 1996;3(11):1024-7.
• 8- Cothren CC, Moore EE.Emergency department thoracotomy for the critically injured patient: Objectives, indications, and outcomes. World J Emerg Surg. 2006;24;1:4.
• 9- Hunt PA, Greaves I, Owens WA. Emergency thoracotomy in thoracic trauma-a review. Injury. 2006;37(1):1-19.
• 10- Meyer DM, Jessen ME, Grayburn PA. Use of echocardiography to detect occult cardiac injury after penetrating thoracic trauma: a prospective study. J Trauma. 1995;39(5):902-7
• 11- Harris DG, Papagiannopoulos KA, Pretorius J, Van Rooyen T, Rossouw GJ. Current evaluation of cardiac stab wounds. Ann Thorac Surg. 1999;68(6):2119-22.
• 12- Rotondo A, Catalano O, Grassi R, Scialpi M, Angelelli G. Thoracic CT findings at hypovolemic shock. Acta Radiol. 1998;39(4):400-4.