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胸椎骨折致钝性胸主动脉损伤的延迟诊断:一例报告及文献复习

Delayed diagnosis of blunt thoracic aortic injury due to thoracic vertebral fracture: A case report and literature review.

作者信息

Lei Xinhuan, Hong Zhenghua, Pan Weixing, Xiang Jie, Luo Hua

机构信息

Department of Orthopedic, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.

Department of Radiology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Taizhou, China.

出版信息

Front Surg. 2022 Oct 20;9:980451. doi: 10.3389/fsurg.2022.980451. eCollection 2022.

Abstract

Blunt vascular injury of the aorta combined with thoracolumbar fracture is rare. Delayed diagnosis may have a catastrophic outcome. We present a case of blunt thoracic aortic injury combined with a vertebral body fracture at T10 after a fall from height in which the diagnosis was delayed. After consultation with the vascular and spinal surgeons, we performed a thoracic endovascular aortic repair. When the patient's condition had stabilized, the fractures were reduced using posterior vertebral instrumentation. Prolonged compression of the thoracic aorta resulted in extensive necrosis of muscle tissues in the right lower leg. Fortunately, clinical and radiological examinations performed 7 months and 1 year later did not reveal any further damage. Cases of thoracic vertebral fracture with concomitant blunt thoracic aortic injury reported in the literature are reviewed. Thoracic endovascular aortic repair is a feasible, safe, and effective minimally invasive treatment for aortic injury when combined with thoracic vertebral fracture.

摘要

主动脉钝性血管损伤合并胸腰椎骨折较为罕见。延迟诊断可能会导致灾难性后果。我们报告一例高处坠落致钝性胸主动脉损伤合并T10椎体骨折且诊断延迟的病例。在与血管外科和脊柱外科医生会诊后,我们进行了胸段血管腔内主动脉修复术。患者病情稳定后,采用后路椎体器械复位骨折。胸主动脉长时间受压导致右小腿肌肉组织广泛坏死。幸运的是,7个月和1年后进行的临床及影像学检查未发现进一步损伤。本文回顾了文献中报道的伴有钝性胸主动脉损伤的胸椎骨折病例。胸段血管腔内主动脉修复术是治疗合并胸椎骨折的主动脉损伤的一种可行、安全且有效的微创治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a475/9630568/191d1b7e7393/fsurg-09-980451-g001.jpg

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