Vashisht Saurabh, Bachhal Vikas, Kumar Vishal, Kumar Deepak
Department of Orthopaedics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Trauma Case Rep. 2019 Jul 27;23:100232. doi: 10.1016/j.tcr.2019.100232. eCollection 2019 Oct.
Lumbar artery pseudoaneurysms following blunt trauma are very rare. We report a case of polytrauma patient having lumbar spine injury and pelvic fracture presenting with hemodynamic instability. The patient did not improve after aggressive resuscitation. There was no evidence of intraabdominal solid organ or visceral injury. We suspected injury to pelvic vessels as a source of bleeding. Computed tomography (CT) angiography was done. A small size (6 × 5 mm) lobulated hyperdense structure is seen in the territory of a left 4th lumbar branch of aorta suggestive of a pseudoaneurysm. Whenever there is a patient of blunt abdominal trauma with pelvic or spine injury and source of bleeding cannot be established, lumbar vessels as a source of bleeding should be kept in mind. CT angiography must be done for diagnosis and patient may subsequently need angioembolization of these vessels.
钝性创伤后腰椎动脉假性动脉瘤非常罕见。我们报告一例多发伤患者,伴有腰椎损伤和骨盆骨折,出现血流动力学不稳定。积极复苏后患者病情无改善。没有腹腔实质器官或内脏损伤的证据。我们怀疑骨盆血管损伤是出血来源。进行了计算机断层扫描(CT)血管造影。在主动脉左第四腰支区域可见一个小尺寸(6×5毫米)的分叶状高密度结构,提示假性动脉瘤。每当有腹部钝性创伤合并骨盆或脊柱损伤且出血来源无法确定的患者时,应考虑腰椎血管作为出血来源。必须进行CT血管造影以明确诊断,患者随后可能需要对这些血管进行血管栓塞治疗。