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Blunt trauma-induced internal thoracic artery injury: case report
1Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Taipei, R.O.C.
Changgeng Yi Xue Za Zhi
|March 1, 2000
Summary
A motorcyclist with severe blunt trauma experienced a rare internal thoracic artery transection, leading to life-threatening bleeding into the chest and mediastinum. Prompt surgical repair stabilized the patient, highlighting diagnostic challenges in such injuries.
Area of Science:
- Trauma Surgery
- Vascular Injury
- Thoracic Surgery
Background:
- Blunt deceleration trauma can cause severe internal injuries.
- Hemodynamic instability and massive hemothorax necessitate urgent surgical intervention.
Observation:
- A 54-year-old motorcyclist presented with grade IV liver injury, hemomediastinum, and right hemothorax post-trauma.
- Initial laparotomy revealed an intact diaphragm, with bleeding originating from the chest.
Findings:
- An isolated internal thoracic artery (ITA) transection was identified as the source of bleeding.
- The ITA injury caused significant anterior mediastinal hematoma and hemothorax.
- Suture ligation of the ITA controlled bleeding and stabilized the patient's hemodynamics.
Implications:
- This case highlights the rarity of isolated ITA transection from blunt trauma.
- Early diagnosis and management are crucial for survival in such complex thoracic injuries.
- Understanding ITA injury mechanisms aids in improving diagnostic accuracy and treatment strategies.
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