Tanizaki Shinsuke, Hayashi Hiroyuki
Department of Emergency Medicine, Fukui Prefectural Hospital, Fukui, Japan.
J Emerg Med. 2012 Dec;43(6):e397-9. doi: 10.1016/j.jemermed.2011.01.017. Epub 2011 Mar 12.
Blunt injuries to the thyrocervical trunk or its branches are rare because these vessels are well protected and located deep in the neck. To the best of our knowledge, we describe the first case of a massive hemothorax after blunt injury to the transverse cervical artery.
A 42-year-old man was brought to our Emergency Department after he fell from a height of 10 meters. On work-up, a massive left hemothorax with extravasation from the left transverse cervical artery and pelvic fractures were detected. Endovascular embolization was successfully performed. There was no evidence of direct injury to the neck, lung laceration, or significant vascular injury that might have caused the massive hemothorax. A shearing mechanism associated with sudden deceleration caused by the 10-meter fall might have caused the transverse cervical artery injury in our patient.
Consideration of injury to the thyrocervical trunk or its branches by the emergency physician will result in more frequent consideration and more timely diagnosis when there is no chest injury and massive hemothorax.
甲状腺颈干及其分支的钝性损伤较为罕见，因为这些血管受到良好保护且位于颈部深处。据我们所知，我们描述了首例颈横动脉钝性损伤后发生大量血胸的病例。
一名42岁男性从10米高处坠落后来到我们的急诊科。检查发现左侧大量血胸，伴有左颈横动脉外渗及骨盆骨折。成功进行了血管内栓塞治疗。没有证据表明颈部有直接损伤、肺裂伤或可能导致大量血胸的重大血管损伤。患者10米高处坠落导致的突然减速相关的剪切机制可能导致了颈横动脉损伤。
当没有胸部损伤和大量血胸时，急诊医生考虑甲状腺颈干或其分支损伤将导致更频繁的考虑和更及时的诊断。
