Nemoto Chiaki, Ikegami Yukihiro, Suzuki Tsuyoshi, Tsukada Yasuhiko, Abe Yoshinobu, Shimada Jiro, Tase Choichiro
Department of Emergency and Critical Care Medicine, Fukushima Medical University School of Medicine, Hikarigaoka-1, Fukushima, Fukushima, 960-1295, Japan,
Gen Thorac Cardiovasc Surg. 2014 Nov;62(11):696-9. doi: 10.1007/s11748-013-0269-6. Epub 2013 Jun 1.
To deal with an arterial bleeding from the chest wall after a blunt chest injury, embolization of the bleeding arteries can be a valuable therapeutic option, which is less invasive than a thoracotomy. However, its results are variable, being highly operator-dependent. In the present case, we performed successful emergency embolization of the 4th and 5th intercostal arteries for persistent hemorrhage following blunt trauma to the chest. Several days after the first embolization, secondary embolization was required for treating a pseudoaneurysm that was formed in the 5th intercostal artery. Although the mechanisms underlying pseudoaneurysm formation are not clearly understood, its rupture is potentially fatal. Therefore, it is essential to carefully follow-up patients who experience blunt chest injury to avoid this serious complication.
对于钝性胸部损伤后胸壁动脉出血的处理，出血动脉栓塞术是一种有价值的治疗选择，其侵入性低于开胸手术。然而，其结果存在差异，高度依赖操作者。在本病例中，我们成功地对钝性胸部创伤后持续出血的第4和第5肋间动脉进行了急诊栓塞。首次栓塞几天后，因第5肋间动脉形成假性动脉瘤而需要进行二次栓塞。尽管假性动脉瘤形成的机制尚不清楚，但其破裂可能致命。因此，对钝性胸部损伤患者进行仔细随访以避免这种严重并发症至关重要。
