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Massive hemothorax after blunt transverse cervical artery injury
Shinsuke Tanizaki1, Hiroyuki Hayashi
1Department of Emergency Medicine, Fukui Prefectural Hospital, Fukui, Japan.
The Journal of Emergency Medicine
|March 15, 2011
Summary
Rare blunt injuries to the transverse cervical artery can cause massive hemothorax. This case report highlights the importance of considering cervical artery injury in patients with unexplained hemothorax after trauma.
Area of Science:
- Trauma Surgery
- Vascular Surgery
- Emergency Medicine
Background:
- Blunt injuries to the thyrocervical trunk or its branches are uncommon due to deep neck anatomy.
- Massive hemothorax typically suggests intrathoracic injury, making non-thoracic vascular sources less suspected.
Observation:
- A 42-year-old male sustained a massive left hemothorax after a 10-meter fall.
- Imaging revealed extravasation from the left transverse cervical artery, with no direct neck trauma or lung injury.
- Pelvic fractures were also noted, suggesting a significant deceleration mechanism.
Findings:
- Successful endovascular embolization of the bleeding left transverse cervical artery was performed.
- The hemothorax was attributed to a shearing injury of the transverse cervical artery secondary to sudden deceleration.
- This represents the first reported case of massive hemothorax from blunt injury to the transverse cervical artery.
Implications:
- Emergency physicians should consider injuries to the thyrocervical trunk and its branches in cases of massive hemothorax without obvious chest trauma.
- Timely diagnosis and endovascular treatment can be life-saving in such rare presentations.
- This case expands the understanding of potential vascular injuries following severe blunt force trauma.
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