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May 1959

Closed Chest Injury

Author Affiliations

U. S. Army
From the Department of Surgery, Walter Reed Army Hospital, Walter Reed Army Medical Center, Washington, D. C.

AMA Arch Surg. 1959;78(5):791-793. doi:10.1001/archsurg.1959.04320050122018

Observation of patients who have suffered ill effects from closed chest trauma reveals a characteristic pattern of injury. Of late, considerable interest and success in the treatment of certain lesions of this type involving the heart and great vessels have tended to enhance the significance of this pattern of injury. In this presentation, a few case reports will be briefly reviewed to emphasize the physiological reasons for their production, the rationale of their treatment, and their clinical pattern.

Most injuries of the chest are not isolated, and many are initially not considered of major significance. It is essential that the late manifestations or complications not be overlooked.

Several case reports of traumatic rupture of the heart with an intact chest wall have appeared since Kellert's initial presentation in 1917.1 Because of the high pressures involved, survival is generally not expected in instances of ventricular rupture. In instances of atrial