Mawaddah Azman, Goh Bee See, Kew Thean Yean, Rozman Zakaria
Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur.
Malays J Med Sci. 2012 Apr;19(2):77-81.
Neurologic and airway compromise as a result of traumatic vascular injuries to the neck region often lead to more severe complications and thus require special consideration. Furthermore, these cases pose diagnostic and therapeutic challenges to healthcare providers. Here, we report a case of a 28-year-old motorcyclist presenting with progressively enlarged Zone 2 neck swelling on the left side following a high impact collision. There were no symptoms or signs suggesting neurologic or laryngeal injury. Computed tomography angiogram of the neck revealed signs of an active arterial bleed. The apparent vascular injury was managed by close observation for signs of airway compromise, urgent angiogram, and selective catheter embolisation of the left lingual artery. The patient subsequently recovered without further operative exploration of the neck. At 6 months post-trauma, the neck swelling fully subsided with no complications from angioembolisation. This case illustrates the individualised treatment and multidisciplinary approach in managing such cases. We review our rationale for this diagnostic and therapeutic approach.
颈部创伤性血管损伤导致的神经和气道损伤常引发更严重的并发症,因此需要特别关注。此外,这些病例给医护人员带来了诊断和治疗方面的挑战。在此,我们报告一例28岁摩托车手的病例,该患者在遭受高冲击力碰撞后,左侧颈部2区肿胀逐渐增大。没有任何症状或体征提示神经或喉部损伤。颈部计算机断层血管造影显示有活动性动脉出血迹象。通过密切观察气道损伤迹象、紧急血管造影以及对左舌动脉进行选择性导管栓塞来处理明显的血管损伤。患者随后康复,未进行进一步的颈部手术探查。创伤后6个月,颈部肿胀完全消退,血管栓塞未出现并发症。该病例说明了处理此类病例的个体化治疗和多学科方法。我们回顾了这种诊断和治疗方法的依据。