Ichiyama Saaya, Ishizawa Yoshiya, Washida Keisuke, Kakehata Shinya, Kakeda Shingo
Emergency and Disaster Medicine, Hirosaki University, Hiorosaki, JPN.
Emergency and Critical Care Center, Aomori Prefectural Central Hospital, Aomori, JPN.
Cureus. 2023 Dec 6;15(12):e50018. doi: 10.7759/cureus.50018. eCollection 2023 Dec.
Gastric artery injury resulting from blunt abdominal trauma is rare, with only eight previous cases documented in the published literature. Our report describes a case involving an injury to the right gastric artery with concomitant injuries to the liver and spleen, for which arterial embolization targeting the right gastric artery was performed. The patient, a 66-year-old woman without any remarkable medical history, was involved in a motor vehicle accident. She was brought to the hospital in a state of shock and complaining of upper abdominal pain. Contrast-enhanced CT indicated hepatic and splenic injuries, intra-abdominal hemorrhaging, and effusion of contrast medium, suggesting involvement of the right gastric artery. Subsequent angiography confirmed irregularities in the diameter of the right gastric artery, prompting coil embolization. A conservative therapeutic approach was selected due to the absence of evidence regarding active hemorrhage or vascular injury within the hepatic or splenic regions. The patient remained clinically stable following the embolization, without any sequelae. Arterial embolization is warranted if preoperative contrast CT indicates signs of hemorrhage, even if hemostasis is ostensibly attained during angiography. Our findings allude to the feasibility of non-operative management (NOM) rather than laparotomy for cases of gastric artery injury.
钝性腹部创伤导致的胃动脉损伤较为罕见,既往发表的文献中仅记录了8例。我们的报告描述了1例涉及右胃动脉损伤并伴有肝脾损伤的病例,针对该病例对右胃动脉进行了动脉栓塞治疗。患者为一名66岁女性,无任何显著病史,遭遇了机动车事故。她被送至医院时处于休克状态,主诉上腹部疼痛。增强CT显示肝脾损伤、腹腔内出血以及造影剂渗出,提示右胃动脉受累。随后的血管造影证实右胃动脉直径不规则,遂进行弹簧圈栓塞。由于没有证据表明肝脾区域存在活动性出血或血管损伤,选择了保守治疗方法。栓塞术后患者临床情况稳定,无任何后遗症。如果术前增强CT显示出血迹象,即使在血管造影时表面上已实现止血,也有必要进行动脉栓塞。我们的研究结果表明,对于胃动脉损伤病例,非手术治疗(NOM)而非剖腹手术是可行的。