Thorakoabdominale Pfählungsverletzung mit Aortenbeteiligung
摘要
Thoracoabdominal impalement injuries involving the aorta represent an extremely rare but highly life-threatening trauma scenario. We report the case of a 50-year-old construction worker who sustained an impalement injury after falling approximately 8m onto an upright standing wooden hammer handle, resulting in thoracoabdominal penetration. The injury resulted in multiple trauma, including damage to the lungs, diaphragm, spleen and kidneys as well as a contained dissection of the thoracic aorta. The patient was treated within the framework of an interdisciplinary, time-critical management approach involving emergency surgical interventions and thoracic endovascular aortic repair (TEVAR). Despite initial hemorrhagic shock and respiratory complications, the patient was successfully stabilized and transferred to inpatient rehabilitation after 6 weeks. This case highlights the importance of structured emergency response systems, advanced endovascular techniques and early psychological trauma care to improve long-term outcomes and prevent posttraumatic stress disorders.