[Innominate artery war injury].

Area of Science:

• Vascular Surgery
• Trauma Surgery
• Military Medicine

Background:

• Explosive war injuries pose significant challenges to vascular structures.
• The innominate artery is a critical vessel, and injury to it is often life-threatening.

Observation:

• A 26-year-old soldier sustained an explosive war injury to the innominate artery from a mortar shell fragment.
• Initial field management included wound packing, intubation, and thoracic drainage.
• Upon arrival at a specialized center, the patient presented with neck swelling, absent right arm pulse, and hemopneumothorax.

Findings:

• Surgical exploration revealed a disrupted right innominate artery bifurcation, necessitating ligation.
• Postoperative aortography confirmed the injury, followed by successful reconstruction using synthetic grafts.
• The patient recovered well with palpable pulses and minimal neurological sequelae (anisocoria).

Implications:

• Early and appropriate field care is crucial for survival in severe vascular trauma.
• Advanced surgical techniques, including reconstructive grafting, can effectively manage complex arterial injuries.
• This case underscores the importance of specialized trauma centers for treating high-risk vascular injuries.