Konno Halleluyah, Nitta Masakazu, Watanabe Norihiro, Miyazato Mitsuyuki, Horiuchi Akane
Department of Emergency Medicine, Tsubame Rosai Hospital, Niigata, Japan.
Turk J Emerg Med. 2024 Jul 1;24(3):172-175. doi: 10.4103/tjem.tjem_253_23. eCollection 2024 Jul-Sep.
Internal thoracic artery (ITA) injuries associated with sternal fractures can lead to shock. Several studies have documented injuries resulting in hemorrhagic shock, yet there is limited reporting on obstructive shock. Opinions differ regarding which is superior between transcatheter arterial embolization (TAE) and open thoracotomy. We report the case of an 80-year-old female patient presented with blunt chest trauma when driving. Her vital signs were normal. However, ultrasonography revealed a hypoechoic anterior mediastinal lesion. Her blood pressure decreased immediately before undergoing a computed tomography (CT) scan. The CT scan showed a sternal fracture, anterior mediastinal extravasation, and dilation of the inferior vena cava. TAE was performed on both internal thoracic arteries, and the patient was transferred to a hospital where an open thoracotomy could be performed. The patient was treated conservatively and discharged without sequelae. Obstructive shock caused by an ITA injury with a sternal fracture can be successfully treated using TAE.
与胸骨骨折相关的胸廓内动脉（ITA）损伤可导致休克。多项研究记录了导致失血性休克的损伤情况，但关于梗阻性休克的报道有限。对于经导管动脉栓塞术（TAE）和开胸手术哪种方法更优，存在不同观点。我们报告了一例80岁女性患者，在驾车时发生钝性胸部创伤。她的生命体征正常。然而，超声检查发现前纵隔有低回声病变。在进行计算机断层扫描（CT）之前，她的血压立即下降。CT扫描显示胸骨骨折、前纵隔造影剂外渗以及下腔静脉扩张。对双侧胸廓内动脉进行了TAE治疗，随后患者被转至可以进行开胸手术的医院。患者接受了保守治疗并出院，无后遗症。胸骨骨折伴ITA损伤引起的梗阻性休克可通过TAE成功治疗。
