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[一例无骨折钝性胸部创伤致锁骨下假性动脉瘤的病例报告]

[A case report of the subclavian pseudoaneurysm due to blunt chest trauma without fracture].

作者信息

Takeshima S, Hatori N, Uryuda Y, Yoshizu H, Tanaka S

机构信息

Department of Surgery II, National Defense Medical College, Saitama, Japan.

出版信息

Nihon Kyobu Geka Gakkai Zasshi. 1997 Nov;45(11):1884-8.

PMID:9430972
Abstract

A young adult patient, 21 years old female, with left subclavian pseudoanurysm caused by blunt chest trauma is reported. The patient was carried to the emergency room of our hospital with the blunt trauma and lung contusion due to the traffic accident. On chest roentgenogram no fractures of ribs and subclavia were seen, but the superior mediastinum was widened. Superior mediastinal hematoma was suspected by CT scan. Following examination of aortogram revealed an pseudoaneurysm of the left subclavian artery at the origin of left internal artery. Emergency operation was performed with left postero-lateral thoracotomy and the aneurysm was located just the point at the bifurcation of internal mammary from left subclavian artery. Internal mammary artery was clipped and the fissure of the subclavian of the subclavian artery was repaired by direct suture under temporary occlusion of the subclavian artery. Postoperative course was uneventful and superior mediastinal hematoma was not noticed on chest roentgenogram and CT of 18 days postoperatively.

摘要

本文报道了一名21岁女性青年成人患者,因钝性胸部创伤导致左锁骨下假性动脉瘤。患者因交通事故致钝性创伤和肺挫伤被送至我院急诊室。胸部X线片未见肋骨和锁骨骨折,但上纵隔增宽。CT扫描怀疑为上纵隔血肿。主动脉造影检查显示左锁骨下动脉在左内动脉起始处有假性动脉瘤。行左后外侧开胸急诊手术,动脉瘤位于左锁骨下动脉与胸廓内动脉分叉处。夹闭胸廓内动脉,在锁骨下动脉临时阻断下直接缝合修复锁骨下动脉裂伤。术后病程顺利,术后18天胸部X线片和CT检查未发现上纵隔血肿。

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