Background: The effectiveness of resuscitative thoracotomy (RT) in pediatric patients with multiple trauma is limited. We present a pediatric case of multiple trauma successfully treated with RT.
Case presentation: A 9-year-old boy was injured after falling down stairs. On arrival, his blood pressure was unmeasurable, and the carotid artery pulse was barely palpable. Sonographic assessment indicated intra-abdominal hemorrhage. RT and aortic cross-clamping were performed, and he received a blood transfusion, after which his circulatory status recovered. Laparotomy indicated an inferior mesenteric vein injury that was sutured. Ten hours after arrival, an acute epidural hematoma was observed and treated with an emergency craniotomy. The patient's condition remained stable and he was discharged on the 101st day.
Conclusion: RT may save the life of patients with multiple trauma, even pediatric patients, if performed in a timely manner, based on the diagnosis of hemorrhagic shock, along with rapid transfusion and hemostatic intervention.
Keywords: focused assessment with sonography for trauma; hemorrhagic shock; multiple trauma; pediatric emergency medicine; thoracotomy.
© 2023 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine.