外傷性巨大肋膜外血種: 案例報告

The clinical figures for traumatic extra-pleural hematoma, the most common injury encountered at an emergency department, have not yet been fully understood by emergency physicians. A lack of an appropriate understanding may lead to patient mortality as a consequence. In this case study, a 72-year-old patient presented with chronic obstructive pulmonary disease and had developed a huge traumatic extra-pleural hematoma as a result of multiple rib fractures after an incident where he had fallen down. After prompt surgical intervention in the form of a thoracotomy, a successful outcome for the patient was obtained. The focus of this study emphasizes the value of chest radiology, computer tomography (CT) and angiography. Interventions such as needle aspiration of or chest tube drainage of the hematoma are not suggested. Surgical interventions should be implemented immediately when there are any signs of respiratory or hemodynamic compromise. This approach has been supported over the past decades in a series of successful reports on surgical intervention after the occurrence of traumatic extra-pleural hematoma.