Traumatic asphyxia is a rare syndrome caused by blunt thoracoabdominal trauma and characterized by cyanosis, edema, and subconjunctival and petechial hemorrhage on the face, neck, upper extremities, and the upper parts of the thorax. Traumatic asphyxia is usually diagnosed by history and inspection; however, the patient should be monitored more closely due to probable complications of thoracoabdominal injuries. Treatment is conservative, but the prognosis depends on the severity of the associated injuries. Herein we present a traumatic asphyxia due to an elevator accident in a 32-year-old male patient and discuss the diagnosis, treatment, and prognosis by reviewing the relevant literature.
Traumatic asphyxia is a rare syndrome resulting from sudden, severe blunt trauma of the thorax and upper abdomen [
A 32-year-old male patient was admitted to the emergency service after an industrial accident, in which an elevator cabin fell on him. The patient was conscious and had stable hemodynamic state on his initial examination. He had dyspnea, back pain, facial cyanosis, subconjunctival hemorrhage, and petechial eruptions on the anterior surface of the thoracic cage and on the left upper extremity (Figures
(a) The patient had bilateral subconjunctival hemorrhage. (b) The patient had facial cyanosis, petechial eruptions on the anterior surface of the thoracic cage and on left upper extremity.
(a) Minimal pneumothorax was detected on computed axial tomography of the chest. (b) Fracture of the transverse processes of the first lumbar vertebrae was detected on computed axial tomography of the lumbar vertebrae.
Chest X-ray of the patient.
The patient was hospitalized in the intensive care unit for follow-up. He was monitored in a continuous fashion. The head of the bed was elevated to 30 degrees to help overcome the increased intracranial pressure. Uninterrupted oxygen therapy was administered. Hemodynamic state of the patient, arterial blood gas analysis, oxygen saturation levels, and hematologic and biochemical parameters were checked at certain intervals. He was taken to the ward since no complication was observed on the first day of the trauma. The symptoms regressed and no complication was observed; thus he was discharged on the fifth day of hospitalization.
Traumatic asphyxia is quite rare [
The extent of the signs and symptoms depend on the duration and severity of the compression that thorax and upper abdomen are exposed to [
Although traumatic asphyxia can be diagnosed easily through short anamnesis and physical examination, other reasons like superior vena cava syndrome and skull base fractures leading to subconjunctival hemorrhage and periorbital ecchymosis must be evaluated [
Traumatic asphyxia cases must be monitored after securing the airway and fixing the cervical spine. Oxygen inhalation therapy and intravenous fluid replacement need to be initiated and the patient shall be intubated and followed on mechanical ventilation as needed [
Traumatic asphyxia has almost perfect prognosis. It heals spontaneously within weeks except the neurological and ocular signs. In cases without accompanying injuries death may occur due to prolonged compression, apnea, and hypoxia [
Traumatic asphyxia is a rare entity. Prognosis usually depends on the duration of the compression and the severity of the accompanying injuries. Quick and careful evaluation of the probable life-threatening conditions in the emergency service is crucial; however oxygen inhalation therapy, efficient ventilation, intravenous hydration, and measures to prevent the increase of intracranial pressure should be initiated as soon as possible.
Written consent form was taken from the patient for using his photographs in this scientific paper.
The authors declare that there is no conflict of interests regarding the publication of this paper.