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Polytrauma due to a very high-speed single light vehicle road traffic accident

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病史

Very high-speed single light vehicle road traffic accident; would appear to have fallen asleep at the wheel, frontal impact, trapped with instrument panel on knees.

 

At the arrival of the Fire department: conscious Glasgow = 15, blood pressure: 110/70 mmHg, heart rate: 100, saturation: 97% in 9 l of oxygen, in considerable pain, reactive intermediate pupils, Morphine titration during release, no signs of respiratory distress, soft abdomen, no guarding, no loss of distal sensitivity.
Dislocation fracture of the left elbow, fracture of the right wrist, open fracture of the left femur, possible fracture of the left foot. Hemodynamic stability during transport. The patient was sent directly to the university hospital for treatment.
At the university hospital: Stable hemodynamics, reactive and symmetric pupils, marked reduction in left breath sounds, pain at peripheral fractures and pain in lumbar spine, abdomen soft, compressible, painless.
The body scan is provided.

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Traumatic diaphragmatic rupture, Thoracic and abdominal injuries, burst vertebral fracture, foot injuries Head CT, Axial plane, Soft tissue window

Head CT, Axial plane, Soft tissue window

Traumatic diaphragmatic rupture, Thoracic and abdominal injuries, burst vertebral fracture, foot injuries Cervical spine, Sagittal plane, Bone window

Cervical spine, Sagittal plane, Bone window

Traumatic diaphragmatic rupture, Thoracic and abdominal injuries, burst vertebral fracture, foot injuries Cervical spine, Coronal plane, Bone window

Cervical spine, Coronal plane, Bone window

Traumatic diaphragmatic rupture, Thoracic and abdominal injuries, burst vertebral fracture, foot injuries  Chest, Abdomen, Pelvis and lower limbs, Arterial phase, Axial plane

Chest, Abdomen, Pelvis and lower limbs, Arterial phase, Axial plane

Traumatic diaphragmatic rupture, Thoracic and abdominal injuries, burst vertebral fracture, foot injuries Chest, Abdomen, Pelvis and lower limbs, Arterial phase, Coronal plane

Chest, Abdomen, Pelvis and lower limbs, Arterial phase, Coronal plane

Traumatic diaphragmatic rupture, Thoracic and abdominal injuries, burst vertebral fracture, foot injuries Chest CT, Lung window, Axial plane

Chest CT, Lung window, Axial plane

Traumatic diaphragmatic rupture, Thoracic and abdominal injuries, burst vertebral fracture, foot injuries Chest, Abdomen and Pelvis, Axial plane, Bone window

Chest, Abdomen and Pelvis, Axial plane, Bone window

Traumatic diaphragmatic rupture, Thoracic and abdominal injuries, burst vertebral fracture, foot injuries Lower limbs, Axial plane, Bone window

Lower limbs, Axial plane, Bone window

Traumatic diaphragmatic rupture, Thoracic and abdominal injuries, burst vertebral fracture, foot injuries Abdomen CT,  Portal venous phase, Axial plane

Abdomen CT, Portal venous phase, Axial plane

Traumatic diaphragmatic rupture, Thoracic and abdominal injuries, burst vertebral fracture, foot injuries Abdomen CT,  Portal venous phase, Coronal plane

Abdomen CT, Portal venous phase, Coronal plane

Traumatic diaphragmatic rupture, Thoracic and abdominal injuries, burst vertebral fracture, foot injuries Abdomen CT, Delayed phase, Axial plane

Abdomen CT, Delayed phase, Axial plane

Traumatic diaphragmatic rupture, Thoracic and abdominal injuries, burst vertebral fracture, foot injuries Lumbar spine, Sagittal plane, Bone window

Lumbar spine, Sagittal plane, Bone window

Traumatic diaphragmatic rupture, Thoracic and abdominal injuries, burst vertebral fracture, foot injuries Left foot, Sagittal plane, Bone window

Left foot, Sagittal plane, Bone window

Traumatic diaphragmatic rupture, Thoracic and abdominal injuries, burst vertebral fracture, foot injuries Left foot, Axial plane, Bone window

Left foot, Axial plane, Bone window

Traumatic diaphragmatic rupture, Thoracic and abdominal injuries, burst vertebral fracture, foot injuries Left foot, Coronal plane, Bone window

Left foot, Coronal plane, Bone window