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December 1963

Acute Thoracic Compression With Traumatic Asphyxia: Report of Six Cases

Author Affiliations

Fellow in Surgery, Mayo Foundation (Dr. Shamblin); Section of Surgery (Dr. McGoon), Mayo Clinic and Mayo Foundation.

Arch Surg. 1963;87(6):967-975. doi:10.1001/archsurg.1963.01310180083014

Acute thoracic compression may produce a striking and characteristic syndrome referred to variously as traumatic asphyxia, ecchymotic mask, pressure stasis, traumatic cyanosis, cervicofacial cutaneous asphyxia, and Perthes' symptom complex.1 It is caused by a crushing injury to the chest or upper abdomen, or both, with a period of apnea. It is characterized by reddish, purplish, or black discoloration of the skin of the face, neck, and shoulders, accompanied by bilateral subconjunctival hemorrhages.

"Traumatic asphyxia," the most common designation of this syndrome, is actually a misnomer. The patients have not been asphyxiated in the usual definition of the term, but instead have suffered from excessive oxygen removal in the cutaneous capillaries due to stasis of blood flow. "Cervicofacial static cyanosis" accurately describes the pathophysiology; but because the term is somewhat cumbersome, "traumatic asphyxia" probably will continue to be used.

Since most recent cases of this entity have been due to

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