Complex polytrauma: Being “switched on’’ as a vascular surgeon

Abstract

A 57-year-old female patient sustained injuries in a road traffic accident when she was travelling in a car collided with a lorry. She suffered injuries to her head, neck, chest, back and right arm. with an episode of loss of consciousness lasting approximately 30 min. She was initially managed at a nearby hospital where her Computed Tomography (CT) brain revealed a thin subdural hemorrhage on the bilateral frontoparietal convexities, subarachnoid hemorrhage in the interhemispheric fissure and bilateral frontoparietal lobes (Fig. 1). CT chest demonstrated fracture of the body of sternum with multiple rib fractures on the left side, fractures of the first rib on either side, bilateral flail chest, bilateral mild hemopneumothorax and a hyperdense hematoma (suspected mural thrombus) in the arch of the aorta, (Fig. 2). CT abdomen revealed no evidence of solid organ injury. She was intubated due to breathlessness followed by a sudden drop in GCS and referred to Kauvery Hospital for further management.