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相關文獻
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題名 | Blunt Trauma-Induced Internal Thoracic Artery Injury: Case Report=鈍傷造成的內乳動脈傷害:病例報告 |
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作者 | 蔡峰鈞; 方禎鋒; 林萍章; 張育生; 張昭雄; | 書刊名 | 長庚醫學 |
卷期 | 22:4 1999.12[民88.12] |
頁次 | 頁666-670 |
分類號 | 416.262 |
關鍵詞 | 鈍傷; 內胸動脈; 血胸; Blunt trauma; Internal thoracic artery; Hemothorax; |
語文 | 英文(English) |
中文摘要 | 我們報告一個54歲男性摩托車騎士,因為急性減速傷害造成第四度肝臟裂傷和危 及生命的縱膈腔出血和右側血胸。大量血胸及給予大量血液輸液仍無改善其生命徵象,使得 緊急手術需立刻進行。正中剖腹來排除腹內出血合併橫膈膜破裂先被施行,但隨即因持續胸 管出血同時發現橫膈膜完整而改成側臥開胸。單獨的內乳動脈完全斷裂被發現,它的持續性 出血造成大量縱膈腔出血同時破到右側胸腔,出血點採用縫合止血後,病人的情況穩定,同 時順利出院。這種罕見的表現將提出報告,同時討論內乳動脈受傷的機制及如何做早期而正 確的診斷。 |
英文摘要 | We report the case of a 54-year-old male motorcyclist with an apparent grade IV liver injury and life-threatening hemomediastinum and right hemothorax following blunt deceleration trauma. Massive hemothorax and an unstable hemodynamic status even under copious blood volume replacement made emergent surgical intervention mandatory. A midline laparotomy was performed at first to rule out abdominal bleeding accompanied by a diaphragmatic tear, but the procedure was soon converted to a thoracotomy after finding an intact diaphragm and persistent bleeding from the chest tube. An isolated internal thoracic artery (ITA) transection was identified. It was actively bleeding and causing a huge anterior mediastinal hematoma and had ruptured into the right pleural cavity. The bleeder was controlled with suture ligation and the hemodynamic status was soon stabilized. The patient recovered without significant sequelae. The rarity of this kind of presentation is discussed, including both the ITA injury mechanism and the problems posed in making an early and correct diagnosis. |
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