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枪伤后上颌内动脉假性动脉瘤:文献综述与病例报告

Pseudoaneurysm in internal maxillary artery after gunshot wound: Critical review and case report.

作者信息

Neres Bruno, Figueiredo Eugênia, Aires Carolina, Nogueira Emerson, Andrade Emanuel

机构信息

DDS - Oral and Maxillofacial Department, Dental School of Pernambuco, University of Pernambuco, Camaragibe, Pernambuco, Brazil.

DDS, MSc - Oral and Maxillofacial Department, Dental School of Pernambuco, University of Pernambuco, Camaragibe, Pernambuco, Brazil.

出版信息

J Clin Exp Dent. 2018 Jul 1;10(7):e716-e720. doi: 10.4317/jced.54849. eCollection 2018 Jul.

Abstract

INTRODUCTION

Pseudoaneurysm is a vascular injury typically caused by rupture of arteries with extravasation of blood. The involvement of this entity in facial arteries after firearm aggression is extremely rare, and they need treatment as early as possible, thus avoiding irreversible damage to patients.

STUDY DESIGN

A 40-year-old male victim of gunshot attack with an entrance orifice in the right posterior cervical region with ascending trajectory, lodging in the ipsilateral zygomatic-orbitary complex, which was submitted to removal of the bone fragments and the bullet. In the intraoperative period, the patient developed profuse hemorrhage and, after complementary examinations, he was diagnosed with pseudoaneurysm of the internal maxillary artery, which was treated by selective endovascular embolization.

RESULTS

The patient was hemodynamically stable, with no complaints and was discharged after 48 hours, without postoperative bleeding recurrences. He had no more complications after 8 months of follow-up.

CONCLUSIONS

The main forms of treatment and diagnosis of vascular lesions are reviewed, and embolization is demonstrated as a technically safe procedure with few complications. Gunshot wound, pseudoaneurysm, maxillary artery, therapeutic embolization.

摘要

引言

假性动脉瘤是一种血管损伤,通常由动脉破裂伴血液外渗引起。火器攻击后该病变累及面动脉极为罕见,需要尽早治疗,从而避免对患者造成不可逆转的损害。

研究设计

一名40岁男性枪击受害者,右后颈部有入口创口,子弹呈上升轨迹,停留在同侧颧眶复合体,接受了骨碎片和子弹取出术。术中患者出现大量出血,经补充检查后,被诊断为上颌内动脉假性动脉瘤,通过选择性血管内栓塞治疗。

结果

患者血流动力学稳定,无不适主诉,48小时后出院,术后无出血复发。随访8个月后无更多并发症。

结论

回顾了血管病变的主要治疗和诊断方式,栓塞术被证明是一种技术上安全、并发症少的手术。枪伤、假性动脉瘤、上颌动脉、治疗性栓塞。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f246/6057077/fecf05b8dba4/jced-10-e716-g001.jpg

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