Hillel Yaffe Medical Center, Hadera, Israel.
Scand J Trauma Resusc Emerg Med. 2009 Sep 24;17:46. doi: 10.1186/1757-7241-17-46.
Combined cervicothoracical vascular traumas are very uncommon, mostly resulting from penetrating injuries. These injuries are accompanied with very high morbidity and mortality rates. In this manuscript we present a case of hemodinamycally unstable trauma patient whose major injury was penetrating trauma of both cervical and mediastinal major vessels. The standard surgical approach of median sternotomy and neck incision was insufficient, and the patient's instability forced the authors to improvise previously not described right-sided trap-door thoracomy. Incorporation of such incision in the surgical arsenal may be very effective in selective cases.
颈椎和胸部联合血管创伤非常少见,主要由穿透性损伤引起。这些损伤伴随着非常高的发病率和死亡率。在本文中,我们介绍了一例血液动力学不稳定的创伤患者,其主要损伤为颈部和纵隔大血管的穿透性损伤。标准的手术入路为正中胸骨切开术和颈部切口,但不够充分,患者的不稳定迫使作者采用了以前未描述的右侧活瓣式开胸术。在选择性病例中,这种入路的应用可能非常有效。