Mirković Nikola, Prokić Marko, Novčić Marija, Arsenijević Miloš, Sretenović Snežana, Knežević Dragan, Kovačević Vojin, Šorak Marija, Kostić Olivera
Vascular Surgery Center, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia.
Department of Surgery, Faculty of Medical Science, University of Kragujevac, 34000 Kragujevac, Serbia.
Medicina (Kaunas). 2024 Dec 31;61(1):49. doi: 10.3390/medicina61010049.
Rupture of the thyrocervical trunk aneurysm into the thoracic cavity does not occur very often. It is an urgent condition due to hemorrhagic shock by massive hemothorax with potentially fatal consequences. Pregnancy and puerperium are additional risk factors for a rupture of the thyrocervical trunk aneurysm in patients with neurofibromatosis and aneurysms. This is the first case of thyrocervical trunk aneurysm rupture after a Cesarean section in a patient with neurofibromatosis type I noted down in the literature. The patient, a 33-year-old woman with neurofibromatosis type I, three days after an already performed Cesarean section had acute pain in the left area of the neck, swelling, and a hematoma that progressed rapidly to respiratory distress, hemothorax, and hemorrhagic shock. Emergency endotracheal intubation was performed for airway control. Urgent computer tomography angiography procedure showed extracranial artery, thyrocervical trunk aneurysm rupture, and vertebral aneurysm without rupture. The patient was urgently and successfully treated by endovascular coil embolization of a ruptured thyrocervical trunk aneurysm and subsequently thoracic drainage for massive hemothorax. Postoperatively, her left neck pain decreased, after which she had no further neurologic deficits. The patient was discharged 10 days later. Thyrocervical trunk aneurysm rupture is a rare condition with a potential outcome of death which requires urgent intervention. Endovascular coil embolization is a minimally invasive, safe, and efficient treatment for patients with rupture of thyrocervical trunk aneurysm and following comorbidities.
甲状腺颈干动脉瘤破裂进入胸腔的情况并不常见。这是一种紧急情况，因为大量血胸导致出血性休克，可能会产生致命后果。妊娠和产褥期是神经纤维瘤病和动脉瘤患者甲状腺颈干动脉瘤破裂的额外危险因素。这是文献中记载的首例Ⅰ型神经纤维瘤病患者剖宫产术后甲状腺颈干动脉瘤破裂的病例。该患者为一名33岁的Ⅰ型神经纤维瘤病女性，在已进行剖宫产术后三天，左侧颈部急性疼痛、肿胀，并出现血肿，迅速发展为呼吸窘迫、血胸和出血性休克。为控制气道进行了紧急气管插管。紧急计算机断层血管造影显示颅外动脉、甲状腺颈干动脉瘤破裂以及未破裂的椎动脉动脉瘤。通过对破裂的甲状腺颈干动脉瘤进行血管内弹簧圈栓塞并随后对大量血胸进行胸腔引流，患者得到了紧急且成功的治疗。术后，她的左侧颈部疼痛减轻，之后未出现进一步的神经功能缺损。患者于10天后出院。甲状腺颈干动脉瘤破裂是一种罕见情况，可能导致死亡，需要紧急干预。血管内弹簧圈栓塞对于甲状腺颈干动脉瘤破裂及相关合并症患者是一种微创、安全且有效的治疗方法。
