Located 14 years old, seated without safety belt in the back of a car, located in a car accident.
It remained in the seat after the event and without loss of knowledge at the time of arrival of the paramedics.
The accident occurred in a rural area and the transfer to the DUP lasted longer.
90min.
It was transported with collaring and immobilized in dorsal decubitus in the protection table.
Vital signs on arrival: temperature, 36.5oC; pulse, 84/min; BP, 110/63mm Hg and respiratory rate 14.
Physical examination (PE) in the UPD showed mild abdominal pain, excoriations in different parts of the body, however the initial ultrasound of the abdomen and X-rays only showed rectification of the cervical spine.
Laboratory studies: normal hemoglobin and creatinine levels; urine test: microhematuria.
After a few hours, the patient presented signs of hemothorax and continued with abdominal pain.
A chest tube was placed in the left hemithorax and a contrast CAT scan was performed.
The CT scan was reviewed in our department.
At this time, the patient had 8hrs under observation.
In our evaluation, we observed ecchymosis in the left flank and poor drainage through the chest tube.
CT showed the left kidney without contrast uptake and a small splenic hematoma.
It was decided to manage conservatively.
The patient was discharged 6 days later.
