自殺企図による穿通性右室損傷の1例

Penetrating Right Ventricular Injury by Suicide Attempt：Report of a Case

はじめに　本邦の胸部外傷による心臓損傷は非穿通性損傷が多く，穿通性損傷は少ない．われわれは，自殺企図による穿通性右室損傷の1例を経験し，救命することができたため報告する．

Penetrating heart injury is rare in Japan. A 35-year-old man stabbed himself with a fruit knife that was about 10 cm in length on the left precordium in an attempt to commit suicide and was transferred to our hospital. His vital signs were stable, and the knife remained stabbed in the left precordium. Cardiac injury and cardiac tamponade were suspected on computed tomography, and emergency surgery was performed. A large amount of red hematoma was found in the mediastinum and the pericardial space after median sternotomy. The knife had created a fissure of about 15 mm in the free wall of the right ventricle, and the injury was repairable. The knife passed through the sixth costal cartilage and the left internal thoracic artery, and hemostasis was easy. The patient’s postoperative course was uneventful, but due to the suicide attempt and adjustment disorder, the patient was transferred to a psychiatric hospital on postoperative day 10.