经导管动脉栓塞治疗无动脉损伤脊柱骨折所致血胸：病例报告及文献复习。
Transcatheter arterial embolization for hemothorax caused by spinal fracture without arterial injury: a case report and review of the literature.
机构信息
Department of Diagnostic and Interventional Radiology, Kobe University Hospital, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Department of Disaster and Emergency Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
出版信息
J Med Case Rep. 2022 Sep 3;16(1):332. doi: 10.1186/s13256-022-03568-4.
BACKGROUND
Spinal fractures rarely cause hemothorax, and no treatment consensus has been reached. Conservative treatment is generally selected in cases without arterial injury, but there have been some reports of uncontrolled bleeding. Here we report a case of hemothorax caused by spinal fracture without arterial injury treated with transcatheter arterial embolization.
CASE PRESENTATION
An 88-year-old Japanese woman with back pain was diagnosed with hemothorax due to bleeding from an unstable fracture of the tenth thoracic vertebra. Contrast-enhanced computed tomography revealed no obvious arterial injury. We performed transcatheter arterial embolization of the bilateral tenth intercostal arteries to prevent rebleeding. The hemothorax did not worsen until surgical spinal fixation 9 days post-transcatheter arterial embolization, and she was discharged 30 days after admission.
CONCLUSION
Transcatheter arterial embolization for hemothorax caused by spinal fractures without obvious arterial injury may be a useful bridge to spinal fixation.
背景
脊柱骨折很少引起血胸，且目前尚无治疗共识。一般来说，对于无动脉损伤的病例，选择保守治疗，但有一些无法控制出血的报告。我们在此报告一例因第十胸椎不稳定骨折引起的脊柱骨折所致血胸，采用经导管动脉栓塞治疗。
病例介绍
一位 88 岁日本女性因背痛被诊断为第十胸椎骨折出血引起的血胸。增强 CT 显示无明显动脉损伤。我们对双侧第十肋间动脉进行了经导管动脉栓塞，以防止再次出血。在经导管动脉栓塞后 9 天进行脊柱固定手术前，血胸没有恶化，患者在入院 30 天后出院。
结论
对于无明显动脉损伤的脊柱骨折引起的血胸，经导管动脉栓塞可能是脊柱固定的有用桥梁。
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