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马来西亚采用胸腹联合切口挽救危及生命的下腔静脉心脏刺伤:一例报告

Thoraco-laparotomy approach to salvage a life-threatening cardiac box stab injury to the infecrior vena cava in Malaysia: a case report.

作者信息

Mahadi Ida Arinah, Tan Jih Huei, Teh Jin Zhe, Mohamad Yuzaidi, Rizal Imran Alwi

机构信息

Department of Surgery, Sultanah Aminah Hospital, Johor Bahru, Malaysia.

出版信息

J Trauma Inj. 2023 Sep;36(3):286-289. doi: 10.20408/jti.2022.0071. Epub 2023 May 19.

Abstract

Torso stab injuries near the cardiac box may present unique challenges due to difficulties in hemorrhage control. For a stab injury to the heart, the repair is straightforwardly performed via median sternotomy. In contrast, injuries to the inferior vena cava are challenging to repair, especially when they are close to the diaphragm, and the bleeding can be torrential. Herein, we describe a case of a self-inflicted stab wound within the "cardiac box." The trajectory of the stab injuries went below the diaphragm and injured the infradiaphragmatic inferior vena cava. Successful emergent repair via the thoraco-laparotomy approach revived the young man. In this report, we revisit and discuss previous large series of patients with this rare vena cava injury.

摘要

由于心脏区域附近的躯干刺伤在控制出血方面存在困难,可能会带来独特的挑战。对于心脏刺伤,可通过正中胸骨切开术直接进行修复。相比之下,下腔静脉损伤的修复具有挑战性,尤其是当损伤靠近膈肌时,出血可能汹涌。在此,我们描述一例发生在“心脏区域”的自伤刺伤病例。刺伤轨迹穿过膈肌下方并损伤了膈下下腔静脉。通过胸腹部联合切开术成功进行急诊修复,使该年轻男子得以康复。在本报告中,我们回顾并讨论了此前大量此类罕见腔静脉损伤患者的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81bd/11309279/735568a7d71f/jti-2022-0071f1.jpg

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