Foley James, Elamien Ahmed, McCann Brendan
Department of Emergency Medicine, University Hospital Waterford, Waterford, Ireland.
J Surg Case Rep. 2021 Mar 13;2021(3):rjab068. doi: 10.1093/jscr/rjab068. eCollection 2021 Mar.
Rupture of the axillary artery in the absence of a fracture of dislocation is a rare traumatic event. An associated injury to the brachial plexus may accompany an axillary artery injury but has rarely been reported in the literature. We present the case of an elderly female, who fell onto an outstretched arm and sustained an axillary artery rupture, combined with a brachial plexus injury. The patient in this case did well post-operatively. The challenge in these cases is early recognition and diagnosis of a vascular injury. A significant mechanism of injury needs to alert the clinician to the possibility of such injuries and if suspected, early investigation and surgical exploration should be initiated to prevent limb ischemia. Subsequently, if the neurological symptoms do not improve, consideration must be given to the possibility of a nerve injury and early recognition and management to prevent long-term functional deficits.
在无骨折脱位情况下腋动脉破裂是一种罕见的创伤事件。腋动脉损伤可能伴有臂丛神经的相关损伤，但文献中鲜有报道。我们报告一例老年女性病例，她摔倒时手臂伸直着地，导致腋动脉破裂并伴有臂丛神经损伤。该病例患者术后恢复良好。此类病例的挑战在于血管损伤的早期识别与诊断。显著的损伤机制需要提醒临床医生警惕此类损伤的可能性，一旦怀疑，应尽早进行检查和手术探查以预防肢体缺血。随后，如果神经症状没有改善，必须考虑神经损伤的可能性，并尽早识别和处理以防止长期功能缺陷。
