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Jerzy Janik, Jacek Kowalski, Jan Rogowski, Lech Anisimowicz
Med Sci Monit 1997; 3(3): CS400-403
This paper presents a case of a fifteen year old female who sustained multiple trauma as the result of a motor vehicle accident. Initially, she was found to have a traumatic rupture of the spleen. Diagnostic laparotomy was performed, and the patient underwent splenectomy and surgical control of the bleeding. Despite this treatment, and despite vigorous fluid and blood replacement, there was persistent hemodynamic instability. Further investigation, specifically bedside echocardiography showed a ventricular septal defect. The patient underwent a second operation with extracorporeal circulation; an alloplastic patch was used to close the septal defect, and the avulsed papillary muscle was repaired. Surgery was successful and the patient was discharged on the 26th day following surgery. The article has been presented at the annual meeting of The Association of Polish Surgeons-Section in Gdansk: "The Case Report of the Year" session held on the 16th of December 1995.