Wiser E H, Cheek R C, Britt L G
Am Surg. 1976 Jun;42(6):430-5.
Four cases of gunshot wounds to the suprarenal abdominal aorta are described. All required prosthetic graft replacement including one or more visceral arterial branches. Two patients survived. Factors important in survival were rapid transportation permitting early resuscitation and retroperitoneal tamponade which delayed exsanguination and permitted stabilization with systematic management. The major problem in management of gunshot wounds of the suprarenal abdominal aorta is limitation of visceral ischemia, particularly hepatic and renal. Special adjuncts such as local renal hypothermia, as used in these cases, or bypass techniques are necessary and should be available before exploration of a periaortic hematoma due to gunshot wound in this area.
本文描述了4例肾上腺区腹主动脉枪伤病例。所有病例均需进行人工血管置换，包括一条或多条内脏动脉分支。2例患者存活。存活的重要因素包括快速转运以便早期复苏，以及腹膜后压迫止血，这延迟了失血并允许通过系统管理实现病情稳定。肾上腺区腹主动脉枪伤治疗中的主要问题是内脏缺血的限制，尤其是肝和肾的缺血。在这些病例中使用的局部肾低温等特殊辅助措施或旁路技术是必要的，并且在探查该区域因枪伤导致的主动脉周围血肿之前就应具备。
