Mueller D K, Greenberg J J, Marshall W J, Maull K I
Department of Surgery, Loyola University Medical Center, Maywood, Illinois 60153, USA.
J Trauma. 1995 Nov;39(5):1010-1. doi: 10.1097/00005373-199511000-00035.
Massive hemorrhage from the deep femoral artery is an uncommon entity in the setting of blunt extremity trauma without femur fracture. A case of deep femoral artery injury causing massive hemorrhage treated by angiographic embolization is reported. In this patient, persistent unexplained hypotension warranted angiographic analysis of a pelvic fracture. Because of a swollen right thigh, the negative pelvic angiogram was extended to include the lower extremity, confirming the diagnosis of a ruptured branch of the deep femoral artery. Bleeding was controlled with embolization that promptly resolved the patient's hemodynamic instability. The salient feature in common with previous reported cases of deep femoral artery injury was hemodynamic instability beyond accountable blood loss. We recommend angiographic analysis with radiological and surgical intervention in the setting of thigh swelling without femur fracture and unexplained hypotension. This management strategy was well tolerated, and the patient received minimal transfusions.
在没有股骨骨折的钝性肢体创伤情况下，股深动脉大出血是一种罕见的情况。本文报告了一例通过血管造影栓塞治疗的股深动脉损伤导致大出血的病例。在该患者中，持续无法解释的低血压需要对骨盆骨折进行血管造影分析。由于右大腿肿胀，阴性的骨盆血管造影扩展至包括下肢，从而确诊为股深动脉分支破裂。通过栓塞控制了出血，迅速解决了患者的血流动力学不稳定问题。与先前报道的股深动脉损伤病例的共同显著特征是血流动力学不稳定超出了可解释的失血范围。我们建议在没有股骨骨折且出现大腿肿胀和无法解释的低血压的情况下，进行血管造影分析并采取放射学和外科干预措施。这种管理策略耐受性良好，患者接受的输血极少。
