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Hemorrhagic shock from breast blunt trauma.

Madden B, Phadtare M, Ayoub Z, Chebl RB - Int J Emerg Med (2015)

Bottom Line: Seat belt use has been associated with decreased life-threatening thoracic injuries.However, it can be associated with life threatening intramammary bleeding.Emergency physicians should be aware of these injuries and their proper management.

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, Memorial Hermann Hospital, Houston, TX, USA, Madden.Bryan@gmail.com.

ABSTRACT

Background: Seat belt use has been associated with decreased life-threatening thoracic injuries. However, there has been an increase in soft-tissue injuries such as breast trauma.

Case report: We describe a case of a young healthy female who presented to a community hospital Emergency department without any trauma designation following a motor vehicle accident. The patient was found to have hemorrhagic shock from an intramammary hemorrhage and was treated with blood products and a temporizing external abdominal binder in preparation for a transfer to a level 1 center where she was successfully treated with angiographic embolization.

Objectives: The objective of this study is to report on a case hemorrhagic shock from a breast hematoma as well as a review of the literature on previous seat belt associated breast trauma and its management in the emergency department.

Conclusion: Seat belt associated breast trauma is uncommon in the emergency medicine literature. However, it can be associated with life threatening intramammary bleeding. Emergency physicians should be aware of these injuries and their proper management.

No MeSH data available.


Related in: MedlinePlus

Breast hematoma sagittal plane with contrast extravasation
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Fig3: Breast hematoma sagittal plane with contrast extravasation

Mentions: Upon arrival to the trauma center, her vitals were as follows: temperature of 36.1 °C, heart rate of 120 bpm, blood pressure of 130/80 mmHg, RR of 20, and a SaO2 of 100 % on nonrebreather. CT angiography of her chest was repeated along with a CT angiophraphy of her abdomen and pelvis. The CT once again showed the breast hematoma, (Figs. 1, 2 and 3) as well as left 4th–8th rib fractures, right 4th–7th rib fractures, and bilateral first rib fractures. Afterwards, she was taken to interventional radiology. Thoracic aortogram, internal mammary, and lateral thoracic branches arteriogram were negative for persistent extravasation. She received a total of three units of PRBCs as well as platelets and FFP during her hospitalization. Her hospital course was remarkable for her large opiate requirement. She was discharged 3 days after admission. Her Hemoglobin at discharge was 10.1 g/dL.Fig. 1


Hemorrhagic shock from breast blunt trauma.

Madden B, Phadtare M, Ayoub Z, Chebl RB - Int J Emerg Med (2015)

Breast hematoma sagittal plane with contrast extravasation
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556717&req=5

Fig3: Breast hematoma sagittal plane with contrast extravasation
Mentions: Upon arrival to the trauma center, her vitals were as follows: temperature of 36.1 °C, heart rate of 120 bpm, blood pressure of 130/80 mmHg, RR of 20, and a SaO2 of 100 % on nonrebreather. CT angiography of her chest was repeated along with a CT angiophraphy of her abdomen and pelvis. The CT once again showed the breast hematoma, (Figs. 1, 2 and 3) as well as left 4th–8th rib fractures, right 4th–7th rib fractures, and bilateral first rib fractures. Afterwards, she was taken to interventional radiology. Thoracic aortogram, internal mammary, and lateral thoracic branches arteriogram were negative for persistent extravasation. She received a total of three units of PRBCs as well as platelets and FFP during her hospitalization. Her hospital course was remarkable for her large opiate requirement. She was discharged 3 days after admission. Her Hemoglobin at discharge was 10.1 g/dL.Fig. 1

Bottom Line: Seat belt use has been associated with decreased life-threatening thoracic injuries.However, it can be associated with life threatening intramammary bleeding.Emergency physicians should be aware of these injuries and their proper management.

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, Memorial Hermann Hospital, Houston, TX, USA, Madden.Bryan@gmail.com.

ABSTRACT

Background: Seat belt use has been associated with decreased life-threatening thoracic injuries. However, there has been an increase in soft-tissue injuries such as breast trauma.

Case report: We describe a case of a young healthy female who presented to a community hospital Emergency department without any trauma designation following a motor vehicle accident. The patient was found to have hemorrhagic shock from an intramammary hemorrhage and was treated with blood products and a temporizing external abdominal binder in preparation for a transfer to a level 1 center where she was successfully treated with angiographic embolization.

Objectives: The objective of this study is to report on a case hemorrhagic shock from a breast hematoma as well as a review of the literature on previous seat belt associated breast trauma and its management in the emergency department.

Conclusion: Seat belt associated breast trauma is uncommon in the emergency medicine literature. However, it can be associated with life threatening intramammary bleeding. Emergency physicians should be aware of these injuries and their proper management.

No MeSH data available.


Related in: MedlinePlus