|SURGICAL TECHNIQUES AND VIDEOS
|Year : 2021 | Volume
| Issue : 1 | Page : 36
Emergency resuscitative thoracotomy for traumatic hemorrhagic shock
Moheb A Rashid
Department of Surgery, Lillehammer Hospital, Lillehammer, Norway; Scandinavian Cardiovascular Surgery Center, Gothenburg, Sweden
|Date of Web Publication||22-Dec-2021|
Moheb A Rashid
Editor-In-Chief, The Journal of Cardiothoracic Trauma
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Rashid MA. Emergency resuscitative thoracotomy for traumatic hemorrhagic shock. J Cardiothorac Trauma 2021;6:36
Not only injury of major vascular structures like, aorta and vena cava, but also minor vascular lesions of the intercostal arteries are challenging and can lead to shock and death. As excellently depicted by professor Mattox of Houston, Texas, in his editorial of this Volume of the Journal, that suture control of the bleeding intercostal artery is sometimes very difficult. That is true as shown in the presented video and reported by Rashid et al. for two decades ago. The current patient who was at his seventies fell down on his left chest and initially had tension pneumothorax that was treated by a chest tube. Later on, we found massive hemothorax with bleeding at the rate of 10 ml per minute and he was found in shock. The patient was taken immediately to the operation for emergency resuscitative thoracotomy on the left side where I found massive bleeding from a lacerated intercostal artery that was successfully sutured with complete cessation of bleeding as shown in the Video.
Thoracic vascular injuries represent a particular challenge to the cardiothoracic and trauma surgeons because they are often detected only at surgery and require a robust level of knowledge and experience of how to perform a quick and safe surgical exposure and control of the bleeder before loosing the patient as the mortality is so high.
The author acknowledges the assistance of Dr. Mohammad Abdelhay Mahdi Rashid, MD, for compromising and editing the video.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Rashid MA, Wikström T, Ortenwall P. Thoracic vascular injuries: A major problem in trauma. Scand Cardiovasc J 2001;35:285-7.
Mattox KL. Editorial – Usual and unusual intrathoracic hemorrhage. J Cardiothorac Trauma 2021;6:1-3. [Full text]