PDF(Pubmed)
Abstract：
We present the case of a victim of a motor vehicle accident in his late 60s who suffered from severe torso injuries. He initially presented with abdominal and chest pain, and underwent emergency laparotomy for hemoperitoneum. After surgery, the patient developed pneumonia and septicemia, which were responsive to antibiotics. The patient was treated with mechanical ventilation in the intensive care unit for approximately 10 days and experienced a severe weight loss of approximately 30%, but slowly recovered without dyspnea. Notably, on hospital day 24, he experienced sudden respiratory distress and flail motion of the chest wall in a general ward. This late presentation of flail chest was attributed to non-union at rib fracture sites, and was likely exacerbated by malnutrition and osteomyelitis. Surgical stabilization of rib fractures and excision of the infected rib were successfully performed. The findings from this case highlight the complexity of managing delayed onset of flail chest. The findings from this case suggest the importance of vigilance for late emerging complications in patients with trauma, even when initial symptoms are absent.
摘要：
我们介绍了一名60多岁的机动车事故受害者的案例，他的躯干严重受伤。他最初表现为腹部和胸部疼痛，并接受了紧急剖腹手术治疗。手术后,患者出现肺炎和败血症,对抗生素有反应。患者在重症监护病房接受机械通气治疗约10天，体重严重下降约30％，但缓慢恢复，没有呼吸困难。值得注意的是,在医院第24天，他在普通病房经历了突然的呼吸窘迫和胸壁连动。连ail胸的晚期表现归因于肋骨骨折部位的不愈合，并可能因营养不良和骨髓炎而加剧。成功进行了肋骨骨折的手术稳定和感染肋骨的切除。从这种情况下的发现强调了控制连ail胸延迟发作的复杂性。从这个案例的研究结果表明，警惕创伤患者晚期出现的并发症的重要性，即使没有最初的症状。
