Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY, United States.
Department of Emergency Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY, United States.
Am J Emerg Med. 2018 Feb;36(2):340.e1-340.e2. doi: 10.1016/j.ajem.2017.10.021. Epub 2017 Oct 7.
Axillary artery injuries can be associated with both proximal humeral fractures (Naouli et al., 2016; Ng et al., 2016) [1,2] as well as shoulder dislocations (Leclerc et al., 2017; Karnes et al., 2016) [3,4]. We report a rare case of an isolated axillary artery truncation following blunt trauma without any associated fracture or dislocation.
A 58-year-old male presented to the emergency department for evaluation after falling on his outstretched right arm. The patient was found to have an absent right radial pulse with decreased sensation to the right arm. Point of care ultrasound showed findings suspicious for traumatic axillary artery injury, and X-rays did not demonstrate any fracture. Computed tomography with angiography confirmed axillary artery truncation with active extravasation. The patient underwent successful vascular repair with an axillary artery bypass. Although extremity injuries are common in emergency departments, emergency physicians need to recognize the risk for vascular injuries, even without associated fracture or dislocation.
腋动脉损伤可与肱骨近端骨折（Naouli 等，2016 年；Ng 等，2016 年）[1,2]以及肩关节脱位（Leclerc 等，2017 年；Karnes 等，2016 年）[3,4]相关。我们报告了一例罕见的钝性创伤后腋动脉截断的病例，无任何相关骨折或脱位。
一名 58 岁男性因右臂伸直摔倒就诊于急诊科。患者右侧桡动脉搏动消失，右臂感觉减退。床边超声检查提示腋动脉创伤性损伤的可疑表现，X 线未见骨折。CT 血管造影证实腋动脉截断伴活动性外渗。患者成功接受腋动脉旁路修复术。尽管四肢损伤在急诊科很常见，但急诊医生需要认识到即使没有相关骨折或脱位，也存在血管损伤的风险。
