Journal of Medical Case Reports | |
Traumatic intercostal arterial bleeding controlled with a novel surgical technique: a case report | |
Tapio Hakala1  Simo Miettinen1  | |
[1] Department of Surgery, North Karelian Central Hospital, Tikkamaentie 16, Joensuu, 80210, Finland | |
关键词: Blunt; Trauma; Thoracotomy; Emergency; Surgery; Hemothorax; Bleeding; | |
Others : 1195394 DOI : 10.1186/1752-1947-6-318 |
|
received in 2011-11-18, accepted in 2012-05-02, 发布年份 2012 | |
【 摘 要 】
Introduction
A blunt thoracic trauma may cause arterial bleeding requiring operative treatment or endovascular embolization or endovascular aortic stenting. A novel damage control technique to stop such bleeding is presented.
Case presentation
We present the case of an 82-year-old Caucasian man who experienced rib fractures I-VII on the left side and bleeding from damaged intercostal arteries after a blunt thoracic trauma. Emergency thoracotomy was performed.
Conclusions
Effective hemostasis was achieved by using a rolled surgical swab and inserting it against the chest wall next to the aorta with sutures pulled through the intercostal muscles and then sutured to the back side of the patient. The patient died four days after the surgery due to a head injury sustained in the car crash.
【 授权许可】
2012 Miettinen and Hakala; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150521095132687.pdf | 469KB | download | |
Figure 2 . | 116KB | Image | download |
Figure 1 . | 42KB | Image | download |
【 图 表 】
Figure 1 .
Figure 2 .
【 参考文献 】
- [1]Yee WY, Cameron PA, Bailey MJ: Road traffic injury in elderly. Emerg Med J 2006, 23:42-46.
- [2]Laszlo K, Schreiber M: Management of the crushed chest. Crit Care Med 2010, 38:469-477.
- [3]O´Connor JVO, Byrne C, Scalea TM, Griffith BP, Neschis DG: Vascular injuries after blunt chest trauma: diagnosis and management. Scand J Trauma Resusc Emerg Med 2009, 17:42. BioMed Central Full Text
- [4]Töpel I, Steinbauer M, Paetzel C, Kasprzak PM: Endovascular therapy of a ruptured intercostal artery aneurysm. J Endovac Ther 2004, 11:219-221.
- [5]Hagiwara A, Yanagawa Y, Kaneko N, Takasu A, Hatanak K, Sakamoto T, Okada Y: Indications for transcatheter arterial embolization in persistent hemothorax. J Trauma 2008, 65:589-594.
- [6]Chemelli AP, Thauerer M, Wiedermaan F, Strasak A, Klocker J, Chemelli-Steinruber IE: Transcatheter arterial embolization for the management of iatrogenic and blunt traumatic intercostal artery injuries. J Vasc Surg 2009, 49:1505-1512.
- [7]Hirshberg A, Mattox K: Top Knife. The Art & Craft Of Trauma Surgery. tfm Publishing Ltd, Castle Hill Barns, Harley, Nr Shrewsbury, UK; 2005:171-174.
- [8]Carillo EH, Heniford BT, Senler SO, Sykes JR, Maniscalco SP, Richarson JD: Embolization therapy as an alternative to thoracotomy in vascular injuries of the chest wall. Am Surg 1998, 64:1142-1148.