Traumatic Pseudoaneurysm of the Superior Mesenteric Artery in a Patient with Blunt Chest Injury

肋骨骨折常併發腹腔實質器官或中空臟器的創傷，然而腹腔內血管創傷則不常被報導。在此我們報告一病患發生摩托車車禍造成的胸部鈍傷併肋骨骨折及氣血胸。經胸管置放術及體液補充後住院。於住院八小時後，病患呈現低血容性休克，顯影後的電腦斷層檢查發現腸系膜上動脈假性血管瘤併破裂及腸系膜內出血，病患於接受經動脈血管栓塞治療後康復出院。於胸部鈍傷或肋骨骨折之病患，即使腹部超音波檢查並無異樣，急診醫師仍應對於腹腔內血管創傷併延遲性的腸系膜內出血等多發性的創傷具有高度警覺，並應考慮使用經動脈血管栓塞治療此類假性血管瘤。

關鍵字

腸系膜上動脈假性血管瘤；胸部鈍傷；經動脈血管栓塞治療；肋骨骨折

並列摘要

Lower rib fracture is regularly associated with abdominal solid organ injuries and, occasionally, with organ perforations. Abdominal vascular injury, however, has rarely been reported with lower rib fractures. We report a patient who had right-side blunt chest trauma with lower rib fractures and hemopneumothorax. Contrast-enhanced computed tomography of the abdomen confirmed a diagnosis of ruptured traumatic pseudoaneurysm arising from the superior mesenteric artery and complicated by intra-mesentery hematoma. A trans-arterial embolization was successful. Emergency physicians should remain alert for associated intra-abdominal vascular injury, especially with delayed intra-mesentery hemorrhage, in patients with blunt chest trauma. CECT of the abdomen should be performed promptly to exclude associated intra-abdominal or retroperitoneal injury. Trans-artery embolization is an effective treatment for traumatic pseudoaneurysm of the superior mesenteric artery.

並列關鍵字

pseudoaneurysm of SMA ； blunt chest trauma ； trans-artery embolization ； rib fractures

國際替代計量

Traumatic Pseudoaneurysm of the Superior Mesenteric Artery in a Patient with Blunt Chest Injury

全文下載

主題瀏覽