Bail H J, Melcher I, Raschke M J, Schroeder R J, Schaser K D
Clinic for Trauma and Reconstructive Surgery, Charité, Campus Virchow Clinic, Humboldt University of Berlin, Germany.
Vasa. 2003 May;32(2):108-10. doi: 10.1024/0301-1526.32.2.108.
A case is reported of a 28-year-old patient with gradually developing massive swelling of the right thigh after sustaining a blunt trauma. 3 1/2 months after the injury, surgery was performed because of a persisting tumor at the thigh. Intraoperatively, massive bleeding occurred, the bleeding vessel was sutured. Postoperative angiography disclosed arteriovenous (av) fistulae from the internal iliacal artery to a gluteal vein as source for the bleeding. The feeding artery was closed by coiling, the patient recovered completely. To the authors' knowledge, development of an av-fistula following blunt trauma has not been described previously. Similarly, the differential diagnosis of a posttraumatic bleeding of a congenital av-malformation was not yet reported. The authors emphasize, that prior to the surgery of inadequately behaving hematomas, an angiography should be performed.
报告了一例28岁患者，在遭受钝性创伤后右大腿逐渐出现大量肿胀。受伤3个半月后，因大腿部肿瘤持续存在而进行了手术。术中发生大量出血，对出血血管进行了缝合。术后血管造影显示，从髂内动脉到臀静脉存在动静脉瘘，这是出血的源头。通过线圈栓塞封闭了供血动脉，患者完全康复。据作者所知，钝性创伤后动静脉瘘的发生此前尚未见报道。同样，先天性动静脉畸形创伤后出血的鉴别诊断也尚未见报道。作者强调，在对表现异常的血肿进行手术前，应进行血管造影。
