Sawamoto Tohru, Aoki Hiromichi, Otsuka Hiroyuki, Morita Seiji, Inoue Shigeaki, Nakagawa Yoshihide, Inokuchi Sadaki
Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Tokai J Exp Clin Med. 2017 Sep 20;42(3):126-129.
An 86-year-old woman was transported by ambulance after jumping from the second floor of a building. Upon arrival, the blood pressure was stable; however, computed tomography indicated the presence of an anterior mediastinal hematoma. Eight hours after arrival, the patient exhibited shock. The blood pressure increased with rapid infusion. Emergency angiography was performed. Extravasation from the musculophrenic artery, which branches off from the left internal mammary artery, was observed. Transcatheter arterial embolization was performed and bleeding was controlled. This is the first report of musculophrenic artery injury caused by blunt trauma to the best of our knowledge. Findings suggested that if an anterior mediastinal hematoma develops, bleeding must be rapidly controlled. If the patient responds to rapid infusion and injury of the internal mammary artery or one of its branches is suspected, transcatheter arterial embolization is considered appropriate.
一名86岁女性从建筑物二楼跳下后被救护车送往医院。到达时血压稳定；然而，计算机断层扫描显示前纵隔血肿。到达后8小时，患者出现休克。快速输液后血压升高。进行了急诊血管造影。观察到从左乳内动脉分支的肌膈动脉有外渗。进行了经导管动脉栓塞术，出血得到控制。据我们所知，这是首例钝性创伤导致肌膈动脉损伤的报告。研究结果表明，如果出现前纵隔血肿，必须迅速控制出血。如果患者对快速输液有反应且怀疑乳内动脉或其分支之一受损，经导管动脉栓塞术被认为是合适的。
