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Thoracoabdominal Injuries

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The Adolescent Athlete

Abstract

A soccer player sustains trauma to his abdomen in a collision with an opponent. The player is taken out of the game, only to return within 2 min feeling little ill effect. He is noted to be coughing, but is able to continue. After the game he is complaining of left upper quadrant abdominal pain. The athletic trainer relates that the player has had a recent upper respiratory tract infection.

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References

  1. Diamond DL. Sports-related abdominal trauma. Clin Sports Med 1989;8(1)91–99.

    CAS  PubMed  Google Scholar 

  2. Gray H. Anatomy of the Human Body. Philadelphia: Lea & Febiger; 1918:1396

    Google Scholar 

  3. Roberts WO. GI trauma in sports. ACSM Team Physician Course Lecture, 2002

    Google Scholar 

  4. Roberts JA. Viral illnesses and sports performance. Sports Med 1986;3(4)296–303.

    Article  Google Scholar 

  5. Sievers EM, Murray JA, Chen D, Velmahos GC, Demetriades D, Berne TV. Abdominal computed tomography scan in pediatric blunt abdominal trauma. Am Surg 1999;65(10)968–971.

    CAS  PubMed  Google Scholar 

  6. Amaral JF. Thoracoabdominal injuries in the athlete. Clin Sports Med 1997;16(4)739–753.

    Article  CAS  PubMed  Google Scholar 

  7. Bliss D, Silen M. Pediatric thoracic trauma. Crit Care Med 2002;30(11); S409–S415.

    Article  PubMed  Google Scholar 

  8. Machida T, Hanazaki K, Ishizaka K, et al. Snowboarding injuries to the chest: Comparison with skiing injuries. J Trauma Inj Infect Crit Care 1999;46:1062–1065

    Article  CAS  Google Scholar 

  9. Richardson JD, Miller FB. Injury to the lung and pleura. In Feliciano DV, Moore EE, Mattox KL, eds. Trauma. 3rd ed. Stamford, CT: Appleton & Lange; 1996:387–407.

    Google Scholar 

  10. Nakayama DK, Rammenofsky ML, Rowe MI. Chest injuries in children. Ann Surg 1989;210:770–775.

    Article  CAS  PubMed  Google Scholar 

  11. Sadat-Ali M, Al-Arfaj AL, Mohanna M. Pneumothorax due to soccer injury [letter]. Br J Sports Med 1986;20(2)91.

    Article  CAS  PubMed  Google Scholar 

  12. Simoneaux SF, Murphy BJ, Tehranzadeh J. Spontaneous pneumothorax in a weight lifter: a case report. Am J Sports Med 1990;18(6)647–648.

    Article  CAS  PubMed  Google Scholar 

  13. Volk CP, McFarland EG, Horsmon G. Pneumothorax: on-field recognition. Phys Sportsmed 1995;23(10)43–46.

    Google Scholar 

  14. Partridge RA, Coley A, Bowie R, Woolard RH. Sports-related pneumothorax. Ann Emerg Med 1997;30(4)539–541.

    Article  CAS  PubMed  Google Scholar 

  15. Erickson S, Rich B. Pulmonary and chest wall emergencies. Phys Sportsmed 1995 23:95–104.

    Google Scholar 

  16. Wagner RB, Crawford WO, Schimpf PP, Jamieson PM, Rao KC. Quantitation and pattern of parenchymal lung injury in blunt chest trauma: Diagnostic and therapeutic implications. J Comput Tomogr 1988;12:270–281.

    Article  CAS  PubMed  Google Scholar 

  17. Bonadio WA, Heimlich T. Post-traumatic pulmonary contusion in children. Ann Emerg Med 1989;18:1050–1052.

    Article  CAS  PubMed  Google Scholar 

  18. Maron BJ, Poliac L, Kaplan JA, Mueller FO. Blunt impact to the chest leading to sudden death from cardiac arrest during sports activities. N Engl J Med 1995;333:337–342.

    Article  CAS  PubMed  Google Scholar 

  19. Curfman GD. Fatal impact: concussion of the heart [editorial]. N Engl J Med 1998;338:1841–1843.

    Article  CAS  PubMed  Google Scholar 

  20. Estes NAM, III. Sudden death in young athletes [editorial]. N Engl J Med 1995;333:380–381.

    Article  PubMed  Google Scholar 

  21. Abrunzo TJ. Commotio cordis: the single, most common cause of traumatic death in youth baseball. AJDC 1991;145:1279–1282.

    CAS  PubMed  Google Scholar 

  22. Kaplan JA, Karofsky PS, Volturo GA. Commotio cordis in two amateur ice hockey players despite the use of commercial chest protectors: case reports. J Trauma 1993;34:151–153.

    Article  CAS  PubMed  Google Scholar 

  23. Link MS, Maron BJ, Van der Brink BA, et al. Impact directly over the cardiac silhouette is necessary to produce ventricular fibrillation in an experimental model of commotio cordis. J Am Coll Cardiol 2001;37:649–654.

    Article  CAS  PubMed  Google Scholar 

  24. Link MS, Wang PJ, Pandian NG, et al. An experimental model of sudden death due to low-energy chest-wall impact (commotio cordis). N Engl J Med 1998;338:1805–1811.

    Article  CAS  PubMed  Google Scholar 

  25. Link MS, Wang PJ, Van der Brink BA, et al. Selective activation of the K +ATP channel is a mechanism by which sudden death is produced by low energy chest-wall impact (commotio cordis). Circulation 1999;100:413–418.

    CAS  PubMed  Google Scholar 

  26. Link MS, Maron BJ, Wang PJ, Van der Brink BA, Zhu W, Estes NAM, III. Upper and lower energy limits of vulnerability to sudden death with chest wall impact (commotio cordis) J Am Coll Cardiol 200341(1):99–104.

    Article  PubMed  Google Scholar 

  27. Ivatury RR. Injury to the heart. In: Feliciano DV, Moore EE, Mattox KL, eds. Trauma. 3rd ed. Stamford, CT: Appleton & Lange; 1996:409–440.

    Google Scholar 

  28. Chang CJ, Graves DW. Athletic injuries of the thorax and abdomen. In: Mellion MB, Walsh MW, Madden C, et al. Team Physicians Handbook. 3rd ed. Philadelphia: Hanley & Belfus; 2001:441–458.

    Google Scholar 

  29. Miles JW, Barrett GR. Rib fractures in athletes. Sports Med 1991;12(1)66–69.

    Article  CAS  PubMed  Google Scholar 

  30. Kirsch MM. Injuries to the chest wall. In: Blunt Chest Trauma. Boston, MA: Little, Brown, and Company; 1977

    Google Scholar 

  31. Cogbill TH, Landercasper J. Injury to the chest wall. In: Feliciano DV, Moore EE, Mattox KL, eds. Trauma. 3rd ed. Stamford, CT: Appleton & Lange; 1996:525–550.

    Google Scholar 

  32. Bailey P. Surfer’s rib: isolated first rib fracture secondary to indirect trauma. Ann Emerg Med 1985;141:346–349.

    Article  Google Scholar 

  33. Brooke, R. Jive fracture of the first rib. J Bone Joint Surg 1959;41B: 370–371

    Google Scholar 

  34. Gurler R, Pavlov H, Torg JS. Stress fracture of the ipsilateral first rib in a pitcher. 1985;13:277–279.

    Google Scholar 

  35. Lankenner PA Jr, Micheli LJ. Stress fracture of the first rib. A case report. J Bone Joint Surg Am 1985;67(1)159–160.

    PubMed  Google Scholar 

  36. Pereira J. Stress fracture of a rib. Br J Sports Med 1985;(1):26.

    Google Scholar 

  37. Saccherti AD, Beswick DR, Morse SD. Rebound rib: stress induced first rib fractures. Ann Emerg Med 1983;12:177–179.

    Article  Google Scholar 

  38. Albers JE, Rath RK, Glaser RS, Poddar PK. Severity of intrathoracic injuries associated with first rib fractures. Ann Thorac Surg 1982;33(6)614–618.

    Article  CAS  PubMed  Google Scholar 

  39. Blichert-Toft M. Fatigue fracture of the first rib. Acta Chir Scand 1969;135:675–678.

    CAS  PubMed  Google Scholar 

  40. Breslin FJ. Fractures of the first rib unassociated with fractures of other ribs. Am J Surg 1937;35:384–389.

    Article  Google Scholar 

  41. Lorentzen Je, Movin M. Fracture of the first rib. Acta Orthopaedica Scanda 1976;47:632–634.

    Article  CAS  Google Scholar 

  42. Tullos HS, Erwin WD, Woods GW, et al. Unusual lesions of the pitching arm. Clin Orthop 1972;88:169–182.

    Article  CAS  PubMed  Google Scholar 

  43. Gregory PL, Biswas AC, Batt ME. Musculoskeletal problems of the chest wall in athletes. Sports Med 2002;32(4)235–250.

    Article  PubMed  Google Scholar 

  44. Colosimo AJ, Byrne E, Heidt RS Jr, Carlonas RL, Wyatt H. Acute traumatic first-rib fracture in the contact athlete: a case report. Am J Sports Med. 2004;32(5)1310–1312. Epub 2004 May18

    Article  PubMed  Google Scholar 

  45. Jenkins SA. Spontaneous fractures of both first ribs. J Bone Joint Surg 1952;34B:9–13.

    Google Scholar 

  46. Lorentzen JE, Movin M. Fracture of the first rib. Acta Orthop Scand 1976;47(6)632–634.

    CAS  PubMed  Google Scholar 

  47. Aitken AP, Lincoln RE. Fracture of the first rib due to muscle pull. N Engl J Med 1939;220:1063–1064.

    Article  Google Scholar 

  48. Brooke R. Jive Fracture of the first rib. J Bone Joint Surg Br 1959;41B:370–371.

    Google Scholar 

  49. Leung HY, Stirling AJ. Stress fracture of the first rib without associated injuries. Injury 1991;22(6)483–484.

    Article  CAS  PubMed  Google Scholar 

  50. Bailey P. Surfer’s rib: isolated first rib fracture secondary to indirect trauma. Ann Emerg Med 1985;14(4)346–349.

    Article  CAS  PubMed  Google Scholar 

  51. Sinha AK, Kaeding CC, Wadley GM. Upper extremity stress fractures in athletes: clinical features of 44 cases. Clin J Sports Med 1999;9(4)199–202.

    Article  CAS  Google Scholar 

  52. Holden DL, Jackson DW. Stress fracture of the ribs in female rowers. Am J Sports Med 1985;13(5)342–348.

    Article  CAS  PubMed  Google Scholar 

  53. Lin HC, Chou CS, Hsu TC. Stress fractures of the ribs in amateur golf players. Zhonghua Yi Xue Za Zhi (Taipei). 1994;54(1)33–37.

    CAS  Google Scholar 

  54. Karlson KA. Rib stress fractures in elite rowers. A case series and proposed mechanism. Am J Sports Med 1998;26(4)516–519.

    CAS  PubMed  Google Scholar 

  55. Christensen E, Kanstrup IL. Increased risk of stress fractures in the ribs of elite rowers. Scand J Med Sci Sports 1997;7(1)49–52.

    Article  Google Scholar 

  56. Gaffney KM. Avulsion injury of the serratus anterior: a case history. Clin J Sports Med 1997;7(2)134–136.

    Article  CAS  Google Scholar 

  57. Lord MJ, Ha KI, Song KS. Stress fractures of the ribs in golfers. Am J Sports Med 1996;24(1)118–122.

    Article  CAS  PubMed  Google Scholar 

  58. Gurtler R, Pavlov H, Torg JS. Stress fracture of the ipsilateral first rib in a pitcher. Am J Sports Med 1985;13(4)277–279.

    Article  CAS  PubMed  Google Scholar 

  59. Proffer DS, Patton JJ, Jackson DW. Nonunion of a first rib fracture in a gymnast. Am J Sports Med 1991;19(2)198–201.

    Article  CAS  PubMed  Google Scholar 

  60. Scott EM, Scott BB. Painful rib syndrome: A review of 76 cases. Gut 1993;34(7)1006–1008.

    Article  CAS  PubMed  Google Scholar 

  61. Wright JT. Clicking rib. Lancet 1973 I:(7809):935.

    Article  Google Scholar 

  62. Parry W, Breckenridege I, Khalil YF. Bilateral clicking ribs. Thorax 1989;44(1)72–73.

    Article  CAS  PubMed  Google Scholar 

  63. Heinz GJ, Zavala DC. Slipping rib syndrome. JAMA 1977;237(8)794–795.

    Article  CAS  PubMed  Google Scholar 

  64. Eastwood NB. Slipping-rib syndrome. Lancet 1980;1898:219–220.

    Google Scholar 

  65. Spence EK, Rosato EF. The slipping rib syndrome. Arch Surg 1983;118(11)1330–1332.

    CAS  PubMed  Google Scholar 

  66. Arroyo JF, Vine R, Reynaud C, Michel JP. Slipping rib syndrome: don’t be fooled. Geriatrics 1995;50(3)46–49.

    CAS  PubMed  Google Scholar 

  67. Selbst SM. Chest pain in children. Am Fam Physician. 1990;41(1)179–186.

    CAS  PubMed  Google Scholar 

  68. Potaris K, Gakidis J, Mihos P, et al. Management of sternal fractures: 239 cases. Asian Cardiovasc Thorac Ann 2002;10:145–149.

    PubMed  Google Scholar 

  69. Athanassiadi K, Gerazounis M, Moustardas M, Metaxas E. Sternal fractures: Retrospective analysis of 100 cases. World J Surg 2002;(10):1243–1246.

    Google Scholar 

  70. Cain TE, Hamilton WP. Scapular fractures in professional football players. Am J Sports Med 1992;20(3)363–365.

    Article  CAS  PubMed  Google Scholar 

  71. McBryde JP. Scapular fracture in a high school football player. Phys Sportsmed 1997;25(10)64–68.

    CAS  PubMed  Google Scholar 

  72. Brown MA, Sikka RS, Cuanche CA, Fischer DA. Bilateral fractures of the scapula in a professional football player. Am J Sports Med 2004;32: 237–242.

    Article  PubMed  Google Scholar 

  73. Miller M, Ada J. Injuries to the shoulder girdle. Skeletal Trauma. 1992;2:1291–1301

    Google Scholar 

  74. Harris RD, Harris JH Jr. The prevalence and significance of missed scapular fractures in blunt chest trauma. AM J Roentgenol 1988;151(4)747–750.

    CAS  Google Scholar 

  75. Bergqvist D, Hedelin H, Karlsson G, Lindblad B, Matzsch T. Abdominal trauma during thirty yrs: Analysis of a large case series. Injury 1981;13:93–99.

    Article  CAS  PubMed  Google Scholar 

  76. Bergqvist D, Hedelin H, Karlsson G, Lindblad B, and Matzsch T. Abdominal injury from sporting activities. Br J Sports Med 1982;16:76–79.

    Article  CAS  PubMed  Google Scholar 

  77. Murphy CP, Drez D. Jejunal rupture in a football player. Am J Sports Med 1987;15:184–185.

    Article  CAS  PubMed  Google Scholar 

  78. Harrison JD, Branicki FJ, Makin GS. Pancreatic injury in association football. Injury 1985;16:232.

    Article  CAS  PubMed  Google Scholar 

  79. Johnson WR, Harris P. Isolated gallbladder injury secondary to blunt abdominal trauma: Case report. Aust NZ J Surg 1982;52:495–496.

    Article  CAS  Google Scholar 

  80. Maehlum S, Daljord OA. Football injuries in Oslo: A one year study. Br J Sports Med 1986;18:186–190.

    Article  Google Scholar 

  81. Speakman M, Reece-Smith H. Gastric and pancreatic rupture due to a sports injury [letter]. Br J Surg 1983;70:190.

    CAS  PubMed  Google Scholar 

  82. Wilton P, Fulco J, O’Leary J, Lee JT. Body slam in no sham. N Engl J Med 1985;313:188–189.

    CAS  PubMed  Google Scholar 

  83. Blankstein A, Salai M, Israeli A, Ganel A, Horoszowski H, Farine I. Ski injuries in 1976–1982: Ybrig region, Switzerland. Int J Sports Med 1985;6:298–300

    Article  CAS  PubMed  Google Scholar 

  84. Hildreth TA, Cass AS, Khan AU. Skiing injuries to the urinary tract. Minn Med 1979;62:155–156.

    CAS  PubMed  Google Scholar 

  85. Jurkovich GJ, Pearce JH, Cleveland HC. Thoracic and abdominal injuries in skiers: The role of air evacuation. J Trauma 1983;23:844–848.

    Article  CAS  PubMed  Google Scholar 

  86. Scharplatz D, Thurleman K, Enderlin P. Thoracoabdominal trauma in ski accidents. Injury 1979;10:86–91.

    Article  Google Scholar 

  87. Kleiman AH. Renal trauma in sports. West J Surg Obstet Gynecol 1961;69:331–340

    CAS  PubMed  Google Scholar 

  88. Pounder DJ. “The grave yawns for the horseman.” Equestrian deaths in South Australia 1973–1983. Med J Aust 1984;141:632–635.

    CAS  PubMed  Google Scholar 

  89. Bergqvist D, Hedelin H, Lindblad B, and Matzsch T. Abdominal injuries in children: an analysis of 348 cases. Injury 1985;16(4)217–220.

    Article  CAS  PubMed  Google Scholar 

  90. Ballham A, Absoud EM, Kotecha MB, Bodiwala GG. A study of bicycle accidents. Injury 1985;16(6)405–408.

    Article  CAS  PubMed  Google Scholar 

  91. Puranik S, Long J, Coffman S. Profile of pediatric bicycle injuries. S Med Journal 1998;91(11)1033–1037.

    CAS  Google Scholar 

  92. Erez I, Lazar L, Gutermacher M, and Katz S. Abdominal injuries caused by bicycle handlebars. Eur J Surg 2001;167(5)331–333.

    Article  CAS  PubMed  Google Scholar 

  93. Friede AM, Azzara CV, Gallagher SS, Guyer B. The epidemiology of injuries to bicycle riders. Pediatr Clin North Am 1985;32:141–151.

    CAS  PubMed  Google Scholar 

  94. Kiburz D, Jacobs R, Reckling F. Bicycling accidents and injuries among adult cyclists. Am J Sports Med 1986;14:416–419.

    Article  CAS  PubMed  Google Scholar 

  95. Sparnon AL, Ford WDA. Bicycle handlebar injuries in children. J Pediatr Surg 1986;21:118–119.

    Article  CAS  PubMed  Google Scholar 

  96. Sartorelli KH, Pilcher DB, Rogers FB. Patterns of splenic injuries seen in skiers. Injury 1995;26(1)43–46.

    Article  CAS  PubMed  Google Scholar 

  97. Machida T, Hanazaki K, Ishizaka K, et al. Snowboarding injuries of the abdomen: comparison with skiing injuries. Injury 1999;30(1)47–49.

    Article  CAS  PubMed  Google Scholar 

  98. Esposito JT, Gamelli RL. Injury to the spleen. In Feliciano DV, Moore EE, Mattox KL, eds. Trauma. 3 ed. Stamford, CT; Appleton & Lange; 1996:525–550

    Google Scholar 

  99. Kaye KM, Kieff E. Epstein-Barr virus infection and infectious mononucleosis. In: Gorbach SL, Bartlett JG, Blacklow NR, eds. Infectious Diseases. Philadelphia: W.B.Saunders; 1992:1646–1654.

    Google Scholar 

  100. Brodsky AL, Heath CW Jr. Infectious mononucleosis epidemiological patterns at United States colleges and universities. Am J Epidemiol 1972;96:87–93.

    CAS  PubMed  Google Scholar 

  101. Rea TD, Russo JE, Katon W, Ashley RL, Buchwald DS. Prospective study of the natural history of infectious mononucleosis caused by Epstein-Barr virus. J Am Board Fam Pract 2001;14:234–242.

    CAS  PubMed  Google Scholar 

  102. Dommerby H, Stangerup SE, Stangerup M, Hancke S. Hepatosplenomegaly in infectious mononucleosis, assessed by ultrasonic scanning. J Laryngol Otol 1986;100:573–579.

    Article  CAS  PubMed  Google Scholar 

  103. Maki DG, Reich RM. Infectious mononucleosis in the athlete: diagnosis, complications, and management. Am J Sports Med 1982;10:162–173.

    Article  CAS  PubMed  Google Scholar 

  104. Askari MM, Begos DG. Spontaneous splenic rupture in infectious mononucleosis: a review. Yale J Biol Med 1997;70:175–182.

    Google Scholar 

  105. Kinderknecht JJ. Infectious mononucleosis and the spleen. Curr Sports Med Rep 2002;1:116–120.

    PubMed  Google Scholar 

  106. Frelinger DP. The ruptured spleen in college athletes: a preliminary report. J Am Coll Health Assoc 1978;26:217.

    CAS  PubMed  Google Scholar 

  107. Burroughs KE. Athletes resuming activity after infectious mononucleosis. Arch Fam Med 2000;9:1122–1123.

    Article  CAS  PubMed  Google Scholar 

  108. Waninger KN, Harcke HT. Determination of safe return to play for athletes recovering from infectious mononucleosis. A literature review. Clin J Sport Med 2005;15(6)410–416.

    Article  PubMed  Google Scholar 

  109. Spielmann AL, DeLong DM, Kliewer MA. Sonographic Evaluation of Spleen size in tall healthy athletes. Am J Roentgenol 2005;184:45–49.

    Google Scholar 

  110. Pachter HL, Liang HG, Hofstetter SR. Liver and biliary tract trauma. In: Feliciano DV, Moore EE, Mattox KL, eds. Trauma. 3rd ed. Stamford, CT: Appleton & Lange; 1996:487–523.

    Google Scholar 

  111. Kleiman AH. Renal trauma in sports. West J Surg Obstet Gynecol 1961;69:331–340

    CAS  PubMed  Google Scholar 

  112. Boone AW, Haltiwanger E, Chambers RL. Football hematuria. JAMA 1955;158:1516–1517.

    CAS  Google Scholar 

  113. Alyea EP, Parish HH. Renal response to exercise. JAMA 1958;167:807–813.

    CAS  Google Scholar 

  114. Peterson NE. Genitourinary trauma. In: Feliciano DV, Moore EE, Mattox KL, eds. Trauma. 3rd ed. Stamford, CT: Appleton & Lange; 1996:661–693.

    Google Scholar 

  115. Renstrom PA. Tendon and muscle injuries in the groin area. Clin Sports Med 1992;20:640–643.

    Google Scholar 

  116. Joesting DR. Diagnosis and treatment of sportsman’s hernia. Curr Sports Med Rep 2002;1(2)121–124.

    PubMed  Google Scholar 

  117. Hackney RG. The sports hernia: a cause of groin pain. Br J Sports Med 1993;27:58–62.

    Article  CAS  PubMed  Google Scholar 

  118. Gilmore OJ. Gilmore’s groin. Sportsmed Soft Tissue Trauma 1992;3:12–14

    Google Scholar 

  119. Fricker PA. Management of groin pain in athletes. Br J Sports Med 1997;31:97–101

    Article  CAS  PubMed  Google Scholar 

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Kerr, H., Curtis, C., d’Hemecourt, P. (2007). Thoracoabdominal Injuries. In: Micheli, L.J., Purcell, L. (eds) The Adolescent Athlete. Springer, New York, NY. https://doi.org/10.1007/978-0-387-49825-6_7

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