Open AccessDelayed diagnosis of traumatic ventricular septal perforation in penetrating chest injury: hematoma formation in the ventricular septum in CT suggests perforation
Author(s) -
Shioya Nobuki,
Inoue Nozomu,
Muto Harutatsu,
Tomita Akiko,
Tsukamoto Yuki,
Kawashima Naonori,
Hazama Koji,
Shichinohe Yasuo
Publication year - 2019
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.419
Subject(s) - medicine , interventricular septum , perforation , cardiac tamponade , radiology , ventricle , surgery , cardiology , punching , materials science , metallurgy
Background Ventricular septal perforation (VSP) can be caused by a penetrating cardiac injury. Diagnosis of VSP tends to be delayed because a shunt might not be detected by color flow Doppler at an early stage following injury. Case presentation A 60‐year‐old man with depression was admitted to the emergency center after a knife injury in the chest. A focused assessment with sonography for trauma revealed cardiac tamponade. Shortly after an open cardiac massage and a pericardiotomy, his spontaneous circulation returned. At a later stage, follow‐up computed tomography, echocardiography, and left ventriculography showed traumatic ventricular septal perforation. Conservative therapy was chosen because the pulmonary blood flow/systemic blood flow ratio was 1.42. Conclusion The initial contrast computed tomography shows a septal hematoma. Its presence could be perceived as a perforation site in the interventricular septum.