Journal of Emergencies, Trauma, and Shock
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CASE REPORT
Year : 2011  |  Volume : 4  |  Issue : 3  |  Page : 425-426

Surviving a delayed trans-diaphragmatic hepatic rupture complicated by an acute superior vena cava and thoracic compartment syndromes


Department of Surgery, Nova Southeastern University College of Osteopathic Medicine, Fort Lauderdale, FL, USA

Correspondence Address:
Michael W Parra
Department of Surgery, Nova Southeastern University College of Osteopathic Medicine, Fort Lauderdale, FL
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-2700.83879

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We describe the first reported survivor of a delayed trans-diaphragmatic hepatic rupture complicated by acute superior vena cava (SVCS) and thoracic compartment syndromes (TCS). A thirty one year old male was involved in a boating accident. The patient was diagnosed with a grade IV liver laceration, which was initially managed with both angio-embolization and open surgical repair. Exactly one month from admission, the patient presented with an abrupt cardiac arrest, which was further complicated by a SVCS and TCS. The SVCS was managed with bilateral thoracostomies which revealed a delayed trans-diaphragmatic hepatic rupture into the right chest cavity. The TCS was managed with a decompressive thoraco-abdominal incision. The patient survived and is now leading a normal life. Our success was largely due to an integrated trauma system of physicians, nurses and technicians that prompted the early recognition of two potentially life threatening complications of a delayed trans-diaphragmatic hepatic rupture.


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