Abstract:
Internal thoracic artery (ITA) injuries associated with sternal fractures can lead to shock. Several studies have documented injuries resulting in hemorrhagic shock, yet there is limited reporting on obstructive shock. Opinions differ regarding which is superior between transcatheter arterial embolization (TAE) and open thoracotomy. We report the case of an 80-year-old female patient presented with blunt chest trauma when driving. Her vital signs were normal. However, ultrasonography revealed a hypoechoic anterior mediastinal lesion. Her blood pressure decreased immediately before undergoing a computed tomography (CT) scan. The CT scan showed a sternal fracture, anterior mediastinal extravasation, and dilation of the inferior vena cava. TAE was performed on both internal thoracic arteries, and the patient was transferred to a hospital where an open thoracotomy could be performed. The patient was treated conservatively and discharged without sequelae. Obstructive shock caused by an ITA injury with a sternal fracture can be successfully treated using TAE.
摘要:
胸骨骨折相关的胸廓内动脉(ITA)损伤可导致休克。几项研究记录了导致失血性休克的损伤,然而,关于阻塞性休克的报道有限。关于经导管动脉栓塞术(TAE)和开胸手术之间的优势,意见不一。我们报告了一名80岁的女性患者在驾驶时出现钝性胸部创伤的情况。她的生命体征正常。然而,超声检查显示前纵隔有低回声病变。在接受计算机断层扫描(CT)扫描之前,她的血压立即下降。CT扫描显示胸骨骨折,前纵隔外渗,下腔静脉扩张.对两个胸内动脉进行了TAE,患者被转移到一家可以进行开胸手术的医院。患者经保守治疗后出院,无后遗症。使用TAE可以成功治疗由ITA损伤和胸骨骨折引起的阻塞性休克。