A case of severe hemorrhagic shock caused by traumatic avulsion of uterine fibroid
Case presentation: A 40-year-old woman was injured in a motor vehicle accident. Physician-staffed helicopter emergency medical service (HEMS) was dispatched, and after the HEMS physician performed thoracostomy and tracheal intubation to relieve the tension pneumothorax and hemorrhagic shock, her car...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-12-01
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| Series: | Trauma Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352644022001017 |
| _version_ | 1811178676842135552 |
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| author | Kazuki Mashiko Yoshiaki Hara Hiroshi Yasumatsu Taichiro Ueda Mariko Yamamoto Yutaka Funaki Yasuko Toshimitsu Yukari Kawaguchi |
| author_facet | Kazuki Mashiko Yoshiaki Hara Hiroshi Yasumatsu Taichiro Ueda Mariko Yamamoto Yutaka Funaki Yasuko Toshimitsu Yukari Kawaguchi |
| author_sort | Kazuki Mashiko |
| collection | DOAJ |
| description | Case presentation: A 40-year-old woman was injured in a motor vehicle accident. Physician-staffed helicopter emergency medical service (HEMS) was dispatched, and after the HEMS physician performed thoracostomy and tracheal intubation to relieve the tension pneumothorax and hemorrhagic shock, her carotid artery became unpalpable. The physician then decided to perform prehospital resuscitative thoracotomy. Immediately after arriving at the hospital, an emergency laparotomy was performed. Intraoperative findings showed that a huge uterine fibroid had been avulsed from the uterine wall, and we performed temporary hemostasis by extraction of the avulsed tumor and application of packing to the pelvic cavity. She was transferred to a rehabilitation hospital 42 days after the operation. Conclusion: The injury mechanism in this case was considered a “submarine effect.” This was an extremely rare case in which the acute care surgeon and a gynecologist collaboratively employed a damage control strategy to deal with impending cardiac arrest. |
| first_indexed | 2024-04-11T06:22:20Z |
| format | Article |
| id | doaj.art-e4a1809e1f344c468936fe31aa76853f |
| institution | Directory Open Access Journal |
| issn | 2352-6440 |
| language | English |
| last_indexed | 2024-04-11T06:22:20Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Trauma Case Reports |
| spelling | doaj.art-e4a1809e1f344c468936fe31aa76853f2022-12-22T04:40:31ZengElsevierTrauma Case Reports2352-64402022-12-0142100705A case of severe hemorrhagic shock caused by traumatic avulsion of uterine fibroidKazuki Mashiko0Yoshiaki Hara1Hiroshi Yasumatsu2Taichiro Ueda3Mariko Yamamoto4Yutaka Funaki5Yasuko Toshimitsu6Yukari Kawaguchi7Corresponding author at: 9-36, Shima, Tsukuba-shi, Ibaraki 305-0833, Japan.; Shock & Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai-city, Chiba 270-1694, JapanShock & Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai-city, Chiba 270-1694, JapanShock & Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai-city, Chiba 270-1694, JapanShock & Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai-city, Chiba 270-1694, JapanShock & Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai-city, Chiba 270-1694, JapanShock & Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai-city, Chiba 270-1694, JapanShock & Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai-city, Chiba 270-1694, JapanShock & Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai-city, Chiba 270-1694, JapanCase presentation: A 40-year-old woman was injured in a motor vehicle accident. Physician-staffed helicopter emergency medical service (HEMS) was dispatched, and after the HEMS physician performed thoracostomy and tracheal intubation to relieve the tension pneumothorax and hemorrhagic shock, her carotid artery became unpalpable. The physician then decided to perform prehospital resuscitative thoracotomy. Immediately after arriving at the hospital, an emergency laparotomy was performed. Intraoperative findings showed that a huge uterine fibroid had been avulsed from the uterine wall, and we performed temporary hemostasis by extraction of the avulsed tumor and application of packing to the pelvic cavity. She was transferred to a rehabilitation hospital 42 days after the operation. Conclusion: The injury mechanism in this case was considered a “submarine effect.” This was an extremely rare case in which the acute care surgeon and a gynecologist collaboratively employed a damage control strategy to deal with impending cardiac arrest.http://www.sciencedirect.com/science/article/pii/S2352644022001017Abdominal hemorrhageDamage control surgeryPrehospital resuscitative thoracotomySubmarine effectUterine fibroid avulsion |
| spellingShingle | Kazuki Mashiko Yoshiaki Hara Hiroshi Yasumatsu Taichiro Ueda Mariko Yamamoto Yutaka Funaki Yasuko Toshimitsu Yukari Kawaguchi A case of severe hemorrhagic shock caused by traumatic avulsion of uterine fibroid Trauma Case Reports Abdominal hemorrhage Damage control surgery Prehospital resuscitative thoracotomy Submarine effect Uterine fibroid avulsion |
| title | A case of severe hemorrhagic shock caused by traumatic avulsion of uterine fibroid |
| title_full | A case of severe hemorrhagic shock caused by traumatic avulsion of uterine fibroid |
| title_fullStr | A case of severe hemorrhagic shock caused by traumatic avulsion of uterine fibroid |
| title_full_unstemmed | A case of severe hemorrhagic shock caused by traumatic avulsion of uterine fibroid |
| title_short | A case of severe hemorrhagic shock caused by traumatic avulsion of uterine fibroid |
| title_sort | case of severe hemorrhagic shock caused by traumatic avulsion of uterine fibroid |
| topic | Abdominal hemorrhage Damage control surgery Prehospital resuscitative thoracotomy Submarine effect Uterine fibroid avulsion |
| url | http://www.sciencedirect.com/science/article/pii/S2352644022001017 |
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