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Cardiac Stab Wound in Remote Area: A Case Report Sukanto, Wega; Tamburian, Christha Z.; Aruperes, Marturia I.
e-CliniC Vol. 13 No. 2 (2025): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v13i2.61045

Abstract

Abstract: Penetrating cardiac injuries are life-threatening emergencies requiring immediate surgical intervention. We presented a case of cardiac stab wound leading to cardiac tamponade and rupture of the pulmonary artery and right ventricle who survived long enough to undergo emergency procedure. A 25-year-old male was stabbed in the left chest approximately nine hours before admission. He experienced chest pain and dyspnea but remained conscious. After initially treated at a local hospital, he was later referred to a tertiary facility. On assessment, he was tachycardic, tachypneic, and had distant heart sounds. Laboratory findings revealed leukocytosis, thrombocytosis, hyperglycemia, metabolic acidosis, lactic acidosis, and anemia. Chest radiograph showed a bottle-shaped heart, passive atelectasis, and a rightward shift of the thoracic vertebrae. The initial suspicion was cardiac tamponade due to myocardial rupture. Sternotomy revealed a pericardial hematoma (150 mL), a right ventricular tear extending to the pulmonary artery, and pneumothorax. Surgical repair was performed with drainage placement. After intervention, echocardiograph examination showed no myocardial damage or infarction, a dysfunction in diastolic which showed an impaired in relaxation of the left ventricle which is a temporary consequence of trauma, pericardial effusion or surgical intervention. In conclusion, this case underscores necessity of early surgical intervention even if this patient succeeded surviving for long hours before surgery. While this patient showed promising recovery, close postoperative monitoring remains crucial to detect functional changes and prevent complications. Keywords: emergency sternotomy; vulnus ictum; chest trauma; sharp cardiac injury; repair of artery pulmonary; rupture of right ventricle
Eight-year-delayed Diaphragmatic Hernia due to a Blunt Trauma: A Case Report Tamburian, Christha Z.; Sukanto, Wega; Pontoh, Pramijaya E.
e-CliniC Vol. 14 No. 2 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v14i2.65952

Abstract

Abstract: Traumatic diaphragmatic rupture is an uncommon but potentially life-threatening injury, typically caused by blunt or penetrating thoraco-abdominal trauma. While most cases are identified in the acute phase, delayed presentations may occur years after the initial injury, often with nonspecific symptoms. Recognition requires a high index of suspicion to avoid morbidity associated with late diagnosis. We reported a 33-year-old male with a history of blunt chest trauma sustained eight years prior, who presented with incidental findings of a left diaphragmatic hernia. The patient was asymptomatic aside from decreased breath sounds on auscultation. Chest computed tomography revealed herniation of abdominal viscera, including the stomach, colon, omentum, and spleen, into the left thoracic cavity. Surgical management consisted of left posterolateral thoracotomy with reduction of herniated contents, adhesiolysis via laparotomy, and primary repair of a 10 × 5 cm diaphragmatic defect using interrupted non-absorbable sutures. Postoperatively, the patient recovered well with resolution of lung expansion and no evidence of recurrence on follow-up imaging. In conclusion, delayed diaphragmatic hernia following blunt trauma is a rare clinical entity that may remain silent for years before diagnosis. Thorough history-taking, clinical suspicion, and advanced imaging are critical in identifying such cases. Early surgical intervention remains the cornerstone of management, aiming to restore diaphragmatic integrity, prevent visceral complications, and optimize respiratory function. Keywords: delayed diaphragmatic hernia; blunt trauma; thoracotomy; diaphragmatic rupture
Delayed Onset of Pseudoaneurysm in Brachial Stab Wound Trauma: A Case Report Tangkilisan, Adrian; Sukanto, Wega; Tamburian, Christha Z.; Paat, Rigel K.; Pontoh, Pramijaya R.
Medical Scope Journal Vol. 8 No. 2 (2026): MEDICAL SCOPE JOURNAL
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v8i2.64553

Abstract

Abstract: Pseudoaneurysms of the extremity are rare and may present acutely or subacutely. Very rarely, the presence of thromboembolism in the aneurysm can result in terminal ischemia, gangrene, and amputation. Only early diagnosis and treatment can prevent progression to significant disability. This case report described a 36-year-old male referred to the hospital with a complaint of a lump in the upper left arm for two months before admission. The patient reported a history of being punctured by a nail, and one week later, an enlarging lump appeared. The patient also complained of a lump on the right chin for one month before hospital admission. The patient was then diagnosed with an impending rupture of the left brachial pseudoaneurysm due to a puncture wound in the left brachial and was scheduled for arterial repair. Although the diagnosis and treatment of the patient were delayed for two months and treated surgically, no immediate or late complications were seen. This case underscores the crucial role of timely diagnosis and surgical treatment, as upper extremity aneurysms can cause severe decreases in function and lead to the loss of an arm or fingers. The successful surgical reconstruction in this case is a motivating example of the preferred treatment for such patients. Keywords:  pseudoaneurysm; brachial artery; repair artery; delayed onset