EMERGENCY CASEBOOK
Case of the month: Intrathoracic rupture of a pectoral muscle haematoma
Emergency Department, Inverclyde Royal Hospital, Greenock, UK
Correspondence to:
Correspondence to:
Dr P Armstrong
peter.armstrong@tuht.scot.nhs.uk
Accepted 10 March 2006
Keywords: haematoma; heparin; pectoral; rib fracture
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Blunt chest wall trauma is a common reason for patients attending emergency departments. It may be the result of assault, falls, or motor vehicle accidents. Injuries sustained range from minor soft tissue damage and uncomplicated rib fractures to life threatening thoracic insults. Pectoral muscle haematomas following rib fractures are rare. We report such a case and discuss the subsequent clinical course and management.
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[in a new window] Figure 1 Large pectoral haematoma. Informed consent was obtained for publication of this figure.
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A 31 year old male intravenous drug user, presented to our emergency department two weeks following a blunt trauma assault, during which he sustained a right sided chest injury. His complaint of right anterior chest pain exacerbated by deep inspiration, coughing, and movement, was associated with pyrexial episodes and night sweats. He was not taking any medication at the time, but was smoking 1015 cigarettes per day.
Clinical examination revealed right sided bronchial breathing, confirmed
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