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J Thorac Cardiovasc Surg 2007;133:588-589
© 2007 The American Association for Thoracic Surgery

Brief Communication

Harm from seat belt: Transthoracic lung herniation and pericardial rupture

Christoph Benckert, MDa,*, Armin Thelen, MDa, Robert Pfitzmann, MDa, Bernhard Gebauer, MDb, Antonino Spinelli, MDa, Sven Jonas, MDa, Peter Neuhaus, MDa

a Department of General, Visceral and Transplantation Surgery, Charité, Campus Virchow, Universitätsmedizin Berlin, Berlin, Germany
b Department of Radiology, Charité, Campus Virchow, Universitätsmedizin Berlin, Berlin, Germany.

Received for publication August 24, 2006; accepted for publication September 25, 2006.

* Address for reprints: Christoph Benckert, MD, Department of General, Visceral and Transplantation Surgery, Charité, Campus Virchow Klinikum, Universitätsmedizin Berlin, Germany, Augustenburger Platz 1, 13353 Berlin, Germany. (Email: christoph.benckert@charite.de).

The first 20% of the full text of this article appears below.

Traumatic rib and sternal fractures mostly occur in association with seat belts in car crashes without airbag deployment.1Go Lung herniation and pericardial rupture are rare concomitant injuries.2,3Go We report a case of traumatic extrathoracic herniation of the lung and pericardial rupture as a consequence of multiple rib fractures and sternal dislocation in a seat belted passenger in a high-velocity car crash.

Clinical Summary

A 79-year-old woman was involved in a severe car crash while sitting in the back seat. Clinical examination in the emergency department showed a left flail chest with subcutaneous emphysema and a massive hematoma left lateral to the sternum. Conventional chest radiography revealed that both lungs were expanded, with bilateral areas of hyperlucency (Figure 1, A). Multislice computed tomography revealed pneumomediastinum (Figure 1, B), bilateral lung contusion, hemothorax, and a herniation of segment 3 of the left lung through a large anterior apical chest wall defect (Figure 1, C), caused by segmented fractures . . . [Full Text of this Article]






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