Tanaka Koichi, Tachibana Naoto, Sato Hirokazu, Uematsu Keigo, Shiba Yosuke, Hamami Gen
Advanced Emergency and Critical Care Center Ehime Prefectural Central Hospital Matsuyama Ehime Japan.
Acute Med Surg. 2015 Nov 12;3(2):199-203. doi: 10.1002/ams2.172. eCollection 2016 Apr.
A 70-year-old man was brought to our hospital emergency department with accidental thermal burns. Surgical tracheostomy was carried out on day 8 after admission, followed by several profuse bleeding episodes from the orifice. Contrast-enhanced computed tomography of the neck revealed a small nodule with arterial phase enhancement that was suspected to be a pseudoaneurysm. During emergency angiography, the nodule was revealed to be a pseudoaneurysm arising from the right superior thyroid artery with contrast medium extravasation.
The patient underwent transcatheter arterial embolization, which resolved bleeding from the tracheostomy orifice.
Pseudoaneurysm of the superior thyroid artery is an extremely rare and life-threatening tracheostomy complication. All clinicians certified to perform tracheostomy should be acquainted with the various complications and methods for managing life-threatening post-tracheostomy complications.
一名70岁男性因意外热烧伤被送至我院急诊科。入院后第8天行外科气管切开术，术后气管造口处多次大量出血。颈部增强CT显示一个在动脉期强化的小结节，怀疑为假性动脉瘤。急诊血管造影显示该结节是一个源于右甲状腺上动脉的假性动脉瘤，伴有造影剂外渗。
患者接受了经导管动脉栓塞术，气管造口处出血得以解决。
甲状腺上动脉假性动脉瘤是一种极其罕见且危及生命的气管切开术并发症。所有有资质进行气管切开术的临床医生都应熟悉各种并发症以及处理危及生命的气管切开术后并发症的方法。
