Yumoto Tetsuya, Sato Keiji, Ugawa Toyomu, Ujike Yoshihito
Advanced Emergency and Critical Care Medical Center, Okayama University Hospital, Okayama, Japan.
Department of Acute Care and Primary Care Medicine, Kawasaki Medical School Hospital, Okayama, Japan.
BMJ Case Rep. 2015 Oct 14;2015:bcr2015211645. doi: 10.1136/bcr-2015-211645.
An 83-year-old woman with no significant medical history was transferred to our tertiary hospital after being hit by a car and presenting with haemorrhagic shock. Immediate fluid resuscitation was performed; physical, chest/pelvic X-ray and echographic examinations did not detect any major sources of bleeding. However, a contrast-enhanced CT scan revealed multiple regions of significant contrast extravasation in an extensive part of the subcutaneous tissue of the patient's lower back, which is an unusual source of bleeding. Transcatheter arterial embolisation of the lumbar and internal iliac arteries and their branches was carried out. In addition, haemostatic resuscitation was performed for damage control resuscitation, which successfully resolved the patient's haemorrhagic shock.
一名83岁无重大病史的女性在被汽车撞后因失血性休克被转至我院三级医院。立即进行了液体复苏;体格检查、胸部/骨盆X光和超声检查未发现任何主要出血源。然而,增强CT扫描显示患者下背部皮下组织广泛区域有多个明显的造影剂外渗区域,这是一个不寻常的出血源。对腰动脉和髂内动脉及其分支进行了经导管动脉栓塞术。此外,为进行损伤控制复苏实施了止血复苏,成功解决了患者的失血性休克。