Shaikh Saamia, Boneva Dessy, Hai Shaikh, McKenney Mark, Elkbuli Adel
Department of Surgery, Kendall Regional Medical Center, Miami, FL, USA.
University of South Florida, Tampa, FL, USA.
Am J Case Rep. 2019 Dec 14;20:1869-1873. doi: 10.12659/AJCR.919090.
BACKGROUND Axillo-subclavian vessel injuries were traditionally the result of combat-related trauma encountered by military surgeons. An increase in gun-related violence in our backyards, however, have brought these injuries to our doorsteps. The majority of the available data explores the management of arterial injuries. There is a deficiency in the literature discussing the management of isolated axillo-subclavian venous injuries. CASE REPORT We report the case of a 25-year-old male who presented after sustaining a gunshot wound to his right lateral chest and axillary area. Computed tomography angiography revealed axillary vein transection. Upon emergent operative intervention, vascular control of the hemorrhage was achieved with ligation of the axillary vein. The patient had an uncomplicated postoperative course and follow up in the office was unremarkable. CONCLUSIONS Axillo-subclavian vessel injuries can result in exsanguination and are associated with a significant mortality risk. Early detection and expeditious management are essential for preserving the patient's limb and preventing the loss of life. Isolated axillary vein injuries can be managed in an unstable patient with ligation and is well-tolerated by patients with an evanescent upper extremity edema.
背景 腋-锁骨下血管损伤传统上是军事外科医生所遇到的与战斗相关创伤的结果。然而，我们周边地区涉枪暴力事件的增加，已将这些损伤带到了我们面前。大多数现有数据探讨了动脉损伤的处理。文献中在讨论孤立性腋-锁骨下静脉损伤的处理方面存在不足。病例报告 我们报告一例25岁男性病例，该患者因右侧侧胸和腋窝区域遭受枪伤前来就诊。计算机断层扫描血管造影显示腋静脉横断。在紧急手术干预时，通过结扎腋静脉实现了对出血的血管控制。患者术后过程顺利，门诊随访情况良好。结论 腋-锁骨下血管损伤可导致大出血，并伴有显著的死亡风险。早期发现和迅速处理对于保全患者肢体和预防死亡至关重要。孤立性腋静脉损伤可在不稳定患者中通过结扎进行处理，且上肢出现短暂性水肿的患者对此耐受性良好。
