摘要:

We report the case of a 32-year-old male who presented to the emergency department with leftsided chest pain associated with burning epigastric discomfort and radiation to the back. Similar symptoms had prompted his visit to another emergency department 1 week earlier. He was discharged from that institution after a negative upper gastrointestinal series. In our emergency department a transoesophageal echocardiograph raised suspicion of a dissection of the thoracic aorta, which was later confirmed by a contrast chest computed tomography scan. The patient was admitted to the intensive care unit but refused surgical intervention at the time of admission. A detailed history failed to uncover any known risk factors for this disease entity. Aortic dissection is rarely seen in young, healthy individuals. Atypical clinical representations are reviewed. The emergency department work-up of aortic dissection is discussed.

ISSN:0969-9546    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

A case of bilateral fractures of the first rib occurring in an otherwise fit road traffic accident victim is described. The only other injuries sustained were of the peripheral limbs. The driver's air bag was inflated during the crash, leading to speculation as to whether this may have contributed to the mechanism of injury. The patient was well oxygenated and cardiovascularly stable with no evidence of neurovascular damage to the thoracic aorta or its branches. Aortic arch aortography was not performed before internal fixation of the peripheral fractures was undertaken under general anaesthesia. A review of the indications for angiography in such patients follows. The policy that patients with fractures of the upper first ribs do not require angiography unless there is other evidence of neurovascular damage is supported.

ISSN:0969-9546    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0969-9546    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0969-9546    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0969-9546    

出版商:OVID    

年代:1995

数据来源: OVID