SEVERE BLUNT THORACOABDOMINAL TRAUMA WITH PERSISTENT SPLENIC VASCULAR INJURY: HYBRID ROOM IS NOT A SUITE, IS A CONCEPT. A VIEW FROM A MIDDLE-INCOME COUNTRY. dradianalaurarodriguezcarrillo@gmail.com

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SEVERE BLUNT THORACOABDOMINAL TRAUMA WITH PERSISTENT SPLENIC VASCULAR INJURY: HYBRID ROOM IS NOT A SUITE, IS A CONCEPT. A VIEW FROM A MIDDLE-INCOME COUNTRY.

7

Mexico

Oral or Poster

High-energy blunt thoracoabdominal trauma can result in life-threatening injuries that require immediate surgical intervention. The integration of a hybrid operating room can be decisive for selected patient survival.

Information was collected about a clinical case where a 61-year-old male suffered a high-speed frontal bicycle collision against a pole. He arrived at the emergency department in critical condition, showing signs of hypovolemic shock and evident ventilatory compromise.

A left chest tube was placed and the ventilatory compromise improved. A positive FAST exam indicates an emergency laparotomy. Intraoperative findings included massive hemoperitoneum, a grade III liver injury, and a grade IV spleen rupture. Damage control maneuvers were performed, including abdominal packing. The patient was transferred to the intensive care unit. Once the patient was hemodynamically stable, he was transferred to an improvised hybrid room equipped with fluoroscopy, where a selective embolization of accessory hepatic and splenic arteries was performed and a reoperation was then carried out, including abdominal lavage and removal of packing. Left flail chest with multiple fractures was fixed. The patient showed a favorable postoperative course following definitive surgery.

The use of an improvised hybrid room allowed timely hemorrhage control in a patient with complex thoracoabdominal trauma, even in low and middle resources settings. We suggest that the hybrid room has to be the concept, not the suite.