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Empalamiento tóraco-abdominal por rama de árbol
Thoracoabdominal impalement by a tree branch
María Teresa Gómez Hernández
, María Rodríguez Pérez, Marcelo Fernando Jiménez
Corresponding author
Departamento de Cirugía Torácica, Hospital Universitario de Salamanca, Salamanca, España
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visualiza fragmento de madera de 20<span class="elsevierStyleHsp" style=""></span>cm de longitud por 2<span class="elsevierStyleHsp" style=""></span>cm de grosor con 2 extremos distales (morfología de Y invertida) que se extiende craneocaudalmente desde el pilar izquierdo del diafragma hasta el músculo psoas y musculatura paravertebral izquierda. Imágenes del campo quirúrgico en el que se aprecia la rama de árbol en la cavidad torácica (C) y del cuerpo extraño (D) una vez extraído bajo visión directa.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Varón de 27 años, que tras caída accidental sobre rama de árbol, sufrió empalamiento tóraco-abdominal con punto de entrada en región infraclavicular izquierda. Se realizó TAC tóraco-abdominal (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>A y B) que mostró enfisema subcutáneo en pared torácica, importante neumotórax izquierdo con colapso pulmonar, lesiones parenquimatosas en ambos lóbulos pulmonares y presencia de cuerpo extraño de densidad aire de 2<span class="elsevierStyleHsp" style=""></span>cm de grosor que se extendía craneocaudalmente desde el pilar izquierdo del diafragma hasta el músculo psoas y músculo paravertebral posterior izquierdo con 2 extremos distales que terminaban a la altura de la cresta ilíaca izquierda.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Se llevó a cabo cirugía urgente, realizándose toracotomía y lumbotomía izquierdas. Los hallazgos quirúrgicos (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>C y D) incluyeron: hemotórax, laceraciones de ambos lóbulos pulmonares, sin lesión vascular ni bronquial y rama de árbol de 20<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>cm con morfología de Y invertida incrustada en diafragma y músculo psoas, en localización retroperitoneal y presencia de restos vegetales en cavidad pleural.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Se realizó extracción del cuerpo extraño bajo control visual directo, lavado y sutura de las laceraciones pulmonares. El postoperatorio transcurrió sin incidencias.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1867 "Ancho" => 1867 "Tamanyo" => 382875 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">TAC tóraco-abdominal (A-B) en el que se visualiza fragmento de madera de 20<span class="elsevierStyleHsp" style=""></span>cm de longitud por 2<span class="elsevierStyleHsp" style=""></span>cm de grosor con 2 extremos distales (morfología de Y invertida) que se extiende craneocaudalmente desde el pilar izquierdo del diafragma hasta el músculo psoas y musculatura paravertebral izquierda. Imágenes del campo quirúrgico en el que se aprecia la rama de árbol en la cavidad torácica (C) y del cuerpo extraño (D) una vez extraído bajo visión directa.</p>" ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005100000009/v2_201509070958/S0300289614003548/v2_201509070958/es/main.assets" "Apartado" => array:4 [ "identificador" => "21422" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Clinical Images / Imágenes clínicas" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005100000009/v2_201509070958/S0300289614003548/v2_201509070958/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289614003548?idApp=UINPBA00003Z" ]
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