Wong Chiu-Wai, Tan Wei-Chean, Yeh Ying-Tung, Chou Ming-Chih, Yeh Chao-Bin
Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
J Emerg Med. 2013 Jun;44(6):1088-91. doi: 10.1016/j.jemermed.2012.06.029. Epub 2013 Jan 16.
Severe craniofacial injury may cause intractable oronasal bleeding, a rare but life-threatening surgical emergency that may occur in the Emergency Department (ED). Uncontrolled massive bleeding is the major cause of mortality. This kind of trauma is usually associated with the transfer of high kinetic energy such as a motor vehicle collision.
We report an unusual case of intractable oronasal bleeding diagnosed by angiography.
A 43-year-old man was brought to the ED after being in a high-energy motor vehicle collision. He had suffered severe craniofacial trauma, including intracranial hemorrhage and intractable oronasal bleeding; he later developed a large pseudoaneurysm arising from the right internal maxillary artery. In the ED, the patient successfully underwent endovascular treatment (EVT) using angiography with transarterial embolization (TAE) therapy to control the bleeding.
EVT by TAE for intractable oronasal bleeding was an effective treatment in this life-threatening situation.
严重的颅面部损伤可能导致难以控制的口鼻部出血，这是一种罕见但危及生命的外科急症，可能发生在急诊科（ED）。无法控制的大量出血是主要的死亡原因。这类创伤通常与高动能的传递有关，如机动车碰撞。
我们报告一例通过血管造影诊断出的难治性口鼻部出血的罕见病例。
一名43岁男性在发生高能量机动车碰撞后被送往急诊科。他遭受了严重的颅面部创伤，包括颅内出血和难治性口鼻部出血；随后他右侧上颌内动脉出现一个大的假性动脉瘤。在急诊科，患者成功接受了血管造影引导下的经动脉栓塞（TAE）治疗这种血管内治疗（EVT）以控制出血。
在这种危及生命的情况下，经动脉栓塞（TAE）进行血管内治疗（EVT）为难治性口鼻部出血提供了一种有效的治疗方法。
