2018 Volume 88 Issue 5 Pages 124-127
Cardiac injury following blunt chest trauma can be fatal; therefore, immediate transportation, correct diagnosis, and early surgical treatment are critical. We describe right atrial appendage rupture due to blunt chest trauma sustained in a motor vehicle accident. A 25-year-old male who was transported to our hospital immediately after a traffic accident arrived in a state of shock. Focused assessment with sonography for trauma revealed cardiac tamponade and pericardiocentesis improved his hemodynamics. Chest computed tomography (CT) showed a right atrial appendage rupture. A clamshell thoracotomy proceeded in the operating room and a large volume of blood erupted. We clamped and sutured three ruptures and placed a drain. The postoperative course was uneventful, and arrhythmia did not occur. The drain was withdrawn on post-operative day (POD) 4 and the patient was discharged from hospital on POD 15 without sequelae. A clamshell thoracotomy is more prompt than a median sternotomy, it does not require specialized equipment, and it is an effective approach to resuscitation after severe chest trauma. The outcome of a ruptured right atrial appendage determined by preoperative CT and cardiac tamponade treated with pericardiocentesis was good. The present report describes this patient and our findings from a literature review.
