Ishida Itaru, Oura Hiroyuki, Kawakami Toru, Shiga Kojiro, Sakatsume Ko, Sasaki Yasuo, Sekizawa Takuro, Handa Masashi
Department of Thoracic Surgery, Iwate Prefectural Central Hospital, Morioka, Japan.
Kyobu Geka. 2013 Jun;66(6):445-8.
A 78-year-old man who fell from a step ladder was transported to our hospital by ambulance under the diagnosis of multiple rib fractures and right hemothorax. Since he was in shock on arrival, endotracheal intubation and tube thoracotomy were immediately performed. Though 2 liters of blood was evacuated, persistent hemorrhage was observed, requiring continuous rapid infusion and blood transfusion. Emergency thoracic arteriography revealed active bleeding from a branch of the right internal thoracic artery. Transcatheter arterial embolization (TAE) was performed using vascular embolization coils and porous gelatin particles. These procedures successfully controlled active hemorrhage from the chest. Intrathoracic hematoma was evacuated through the 2nd large chest tube. Chest tubes were removed on the 7th day. He was discharged on the 17th day without any complications.
一名78岁男性从阶梯式梯子上跌落，被救护车送往我院，诊断为多根肋骨骨折和右侧血胸。由于他入院时处于休克状态，立即进行了气管插管和开胸引流术。尽管引出了2升血液，但仍观察到持续出血，需要持续快速输液和输血。急诊胸部动脉造影显示右胸廓内动脉分支有活动性出血。使用血管栓塞线圈和多孔明胶颗粒进行了经导管动脉栓塞术（TAE）。这些操作成功控制了胸部的活动性出血。通过第二根大口径胸管引出了胸腔内血肿。胸管在第7天拔除。他在第17天出院，无任何并发症。
