2018 Research Forum

DISCUSSION Breast hematomas are relatively uncommon among female patients with blunt chest trauma, occurring in less than 2% of female blunt chest trauma cases, according to a systematic review at a large level 1 trauma center1. Further, more than 93.5% were managed expectantly with only 6.5% requiring an invasive intervention, most of which were performed by endovascular arterial embolizations1. In our case, the images indicate a hemodynamically compromising breast hematoma in a patient where no other injuries were found on a pan-CT scan (Image 2). To our knowledge, this is the only reported case of female with a massive breast hematoma resulting from blunt chest trauma demonstrating no other radiographically or physically-evident injuries and class 3 shock requiring open surgical intervention. CONCLUSION Cases of isolated large breast hematomas causing class 3 shock, to our knowledge, have not been reported in the literature. It is hoped that by publishing this case report with supporting images, other emergency medicine physicians will have increased index of suspicion for acute breast hematomas in cases where other body compartments have no evidence of injury. REFERENCES 1. Sanders, Christopher, James Cipolla, Christy Stehly, and Brian Hoey. “Blunt Breast Trauma: Is There a Standard of Care?” The American Surgeon 77, no. 8 (August 2011): 1066–69.

28