Don’t Lose Your Heart to a Car. Extracorporeal Ejection of the Heart by Forceful Upward Thoraco-abdominal Blunt Trauma in Human and Animal.

The traumatic extracorporeal ejection of a beating heart has not been witnessed and reported in the literature previously, to our knowledge. Here we present two cases of vehicle accidents leading to this fatal injury, both in a rabbit and a human. Case 1. One late evening in June, in the land of the midnight sun, a young man was driving to his favourite fishing river for a spot of trout fishing in a remote part of Eastern Finland. While driving his aged Nissan Almera at 60 km/h down a dusty gravel road on this dusky night, suddenly a young male rabbit jumped onto the road and appeared in the beam of his headlights. Despite the man’s evasive manoeuvres, the rabbit was struck by the left front corner of the car. After hitting the brakes and the car eventually coming to a standstill, the young man went to inspect the animal he had hit…. In conclusion, we present that in a very rare constellation of forceful blunt trauma to the chest, the heart can be completely avulsed and ejected from the body in human as in animals. Larger prospective and randomised studies are probably not needed to confirm these findings. Just be careful – it is possible to lose your heart to a car.

Abdominal blunt trauma in children: experience from a single center

Background: Abdominal blunt trauma (ABT) remains an important cause of childhood morbidity and sometimes, mortality. Recently the approach for management of ABT has tilted towards conservative one with excellent results. In this study, we present our experience of ABT from a teaching hospital.Methods: All patients below 17 years with ABT between December 2012 and May 2016 were studied retrospectively and methods and results analyzed.Results: A total of 33 patients presented with ABT, mainly due to fall from height or road-traffic accidents. Age ranged from 3 to17 years. Of the 33 patients, 30 patients had solid organ injuries and only 3 patients had isolated hollow viscus injuries. Operative intervention was needed in 6 (18.2%) patients, of whom three needed upfront surgery. They had had hollow viscus injury. Others who developed signs and symptoms of other injuries included duodenal injury, ureteric transection and delayed adhesive intestinal obstruction following bile leak, one each. Average hospital stay of patients with solid organ injury was 5.4±1.6 days while for those with hollow viscus injury requiring operative intervention, this was 12.3±2.4 days. There was no mortality.Conclusions: ABT is a frequent emergency in children in the developing world. Prompt initial management significantly affects the eventual outcome. Imaging studies are the cornerstone of diagnosing the type and extent of injury. Most patients can be managed conservatively. However, constant masterly vigilance is needed to pick up the evolving signs, thereby avoiding possible complications and morbidity.