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摩托车车把撞击导致股总动脉钝性创伤:一例广泛血栓形成病例

Blunt Trauma to the Common Femoral Artery From Motorcycle Handlebar Impact: A Case of Extensive Thrombosis.

作者信息

Balachandra Santhosh, Uniyal Madhur, Pareek Amit, Chauhan Rohit, Jaiswal Ayush

机构信息

Trauma Surgery and Critical Care, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.

Trauma and Acute Care Surgery, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.

出版信息

Cureus. 2025 Jun 18;17(6):e86291. doi: 10.7759/cureus.86291. eCollection 2025 Jun.

Abstract

Blunt trauma can cause significant vascular injury even in the absence of fractures or penetrating wounds, and such injuries are often underdiagnosed. In this case, the rarity lies in the intraoperative identification of an unusually extensive thrombus measuring 71 cm in length - an exceptional finding rarely described in blunt vascular trauma. We report a case of a 59-year-old male who sustained trauma to the left groin from a motorcycle handlebar impact during a road traffic accident. He presented six hours after the incident with absent distal pulses and delayed capillary refill in the affected limb. Computed tomography angiography revealed complete non-opacification of the left common femoral artery and proximal superficial femoral artery over a 4.4 cm segment, suggestive of arterial thrombosis. Emergency surgical exploration confirmed the thrombus, which was successfully extracted using a Fogarty catheter. The contused arterial segment was resected, and a tension-free end-to-end anastomosis was completed using a 6-0 Prolene suture. Based on clinical assessment, the limb ischemia was classified as Rutherford Grade IIa, indicating a marginally threatened limb requiring prompt intervention. Postoperatively, limb perfusion was restored with no signs of ischemic complications, and the patient regained full function. At six-week follow-up, triphasic flow was confirmed on Doppler ultrasound. This case underscores the importance of maintaining a high index of suspicion for vascular injury in blunt trauma patients, particularly when skeletal injury is absent. Early diagnosis and timely surgical management are vital to prevent limb loss and ensure favorable outcomes.

摘要

钝性创伤即使在没有骨折或穿透伤的情况下也可能导致严重的血管损伤,而此类损伤常常被漏诊。在此病例中,罕见之处在于术中发现了一条异常长的血栓,长度达71厘米——这是钝性血管创伤中极少描述的特殊发现。我们报告一例59岁男性,在道路交通事故中因摩托车车把撞击导致左腹股沟创伤。事故发生6小时后,他就诊时患侧肢体远端脉搏消失且毛细血管再充盈延迟。计算机断层血管造影显示左股总动脉和股浅动脉近端4.4厘米节段完全不显影,提示动脉血栓形成。急诊手术探查证实了血栓的存在,使用Fogarty导管成功取出。切除挫伤的动脉节段,用6-0普理灵缝线完成无张力端端吻合。根据临床评估,肢体缺血被分类为卢瑟福IIa级,表明肢体受到轻微威胁,需要立即干预。术后,肢体灌注得以恢复,无缺血并发症迹象,患者恢复了全部功能。在六周随访时,多普勒超声证实有三相血流。该病例强调了对钝性创伤患者的血管损伤保持高度怀疑的重要性,尤其是在没有骨骼损伤的情况下。早期诊断和及时的手术治疗对于防止肢体丧失和确保良好预后至关重要。

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