抄録
Schizophrenia is one of the most important diseases in the psychiatric field, however childhood onset is rare in schizophrenia. In this report, we describe a case of multiple traumas in a 13-years-old female with schizophrenia. She jumped from a sixth-floor window, and then was taken to our emergency center in an ambulance on December _??_, 1999. She had a medical history of emotional disorder. At the initial medical examination, she said that an alien had ordered her to jump from the window.
Radiographic examination showed bilateral pubic and ischial bone fractures of the pelvis, the greater trochanter and the neck of the left femur. Oral examination demonstrated fractured teeth and gingival bleeding on the mandible. Fractured teeth were from the lower first incisor on the left side to the contralateral lower first premolar, and accompanied with alveolar bone fractures. Head x-ray examination showed fractures of the median mandibular body and angle on the left side. However, occlusion was stable and there was no deviation of the mandibular fragments. Thereafter hemorrhagic shock developed, and the systolic blood pressure ranged from 35 to 45mmHg because of bleeding from the internal iliac artery on the left side. Then she underwent embolization of the artery. Airway intubation to control respiration was performed by a transnasal approach because of her maxillofacial injuries. Thereafter, we extracted the fractured teeth and performed alveoloplasty. The mandibular fractures were treated by external fixation for 2 weeks. The prognosis was good after fixation. Her general condition recovered, and she was diagnosed as having schizophrenia by a psychiatrist at our center. It is considered that dentists should participate in the emergency care of patients with multiple traumas including maxillofacial traumas, and cooperate with other departments.
