TorsoTrauma

Abstract

A 30-year-old male was hit by a motor vehicle about 3 h ago. At presentation, he had a threatened airway with labored breathing; his respiratory rate was 32/min with O ₂saturation of 85%. He had paradoxical chest movements and decreased air entry on the left side. His heart rate was 120/min, blood pressure was 100/80 mmHg, and Glasgow coma scale (GCS)score was 15/15. After initial stabilization and left-sided intercostal drainage (ICD), secondary survey revealed abdominal distention with tenderness over the left upper quadrant of the abdomen. A computed tomography (CT) scan of the chest and abdomen showed multiple rib fractures on the left side of the chest with underlying lung contusion and ICD in situ. It also revealed a shattered spleen and 3-cm laceration in segment 6 of the liver along with 1-cm laceration in the upper pole of the left-sided kidney and pneumoperitoneum suggesting both solid and hollow viscous injury. Exploratory laparotomy was performed. The liver and kidney were preserved, while the spleen was removed, primary repair of bowel segment was performed. The patient gradually recovered in intensive care unit (ICU).