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題名 | Traumatic Thoracic Aortic Injury Caused by a Sharp Edge of Left Fractured Rib on Body Position Change: Case Report=左側肋骨骨折刺傷胸部主動脈:病例報告 |
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作者 | 徐榆堡; 陳瑞杰; 卜樂得; 方禎鋒; 林炳川; Hsu, Yu-pao; Chen, Ray-jade; Bullard, Michael J.; Fang, Jen-feng; Lin, Being-chuan; |
期刊 | 長庚醫學 |
出版日期 | 19980900 |
卷期 | 21:3 1998.09[民87.09] |
頁次 | 頁343-346 |
分類號 | 416.263 |
語文 | eng |
關鍵詞 | 肋骨背部骨折; 主動脈傷害; Rib posterior fracture; Aortic injury; |
中文摘要 | 左側肋骨骨折剌傷胸部主動脈的病例是相當罕見。本病例為一位66歲女性病人, 工作時由梯子上跌落地面。CXR顯示左側多重肋骨骨折(第三到第八根肋骨),合併血胸及 胸中隔變寬。胸部電腦斷層顯示左側第六根肋骨背部骨折的尖端插入胸部主動脈。病人於受 傷 7小時後,左側胸管大量出血。主動脈攝影顯示,於左側第六根肋骨骨折處,有大量滲血 現象。很不幸地,由於大量出血及手術時間的延遲,病人終於死亡。因此,對於胸部挫傷病 人,合併有胸中膈變寬及影像攝影懷疑有主動脈傷害,應儘早發現並立即外科手術治療。 |
英文摘要 | Aortic injury caused by penetration of a fractured rib is very rare. We present a patient with aortic injury demonstrated using serial imaging studies. A 66-year-old woman fell from a ladder and sustained multiple left-side rib fractures. There was a small left hemothorax and widened mediastinum on the initial chest roentgenogram in the emergency department. Chest computed tomography (CT) revealed a posterior segmental fracture of the sixth rib on the left side with a sharp edge penetrating into the posterior aspect of the thoracic aorta. It was initially missed. More than 1000cc of fresh blood suddenly gushed out of the chest tube 7 hours after the traumatic event. After resuscitation, and aortogram was performed which showed blood extravasation from the thoracic aorta at the rib fracture site. Unfortunately, surgical intervention was delayed and she died. Early detection and early surgical intervention are necessary in patients with a widened mediastinum and positive results on imaging studies. |
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