管胸切除术后的胸脊动脉损伤:一个案例报告
Jun Kamei1, Akira Kuriyama1, Tsuyoshi Ohno2
1Department of Primary Care and Emergency Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
The Journal of emergency medicine
|September 10, 2023
概括
管胸切除术可能导致罕见但严重的出血并发症. 紧急医生必须密切监测患者在胸管放置后出血,即使在"安全三角形",由于潜在的胸脊动脉损伤.
科学领域:
- 胸部外科手术 胸部外科手术
- 血管外科 血管外科
- 紧急医疗 紧急医疗
背景情况:
- 管胸切除术是一种常见的程序,用于管理腔空间异常.
- 严重的出血并发症很少见,但可能发生.
- 肋间动脉损伤是已知的并发症,但其他血管损伤的报道较少.
研究的目的:
- 报告一个罕见的发生在管胸切除术后胸脊动脉损伤的病例.
- 突出了胸腔管放置可能导致严重出血并发症的可能性,即使在"安全三角".
- 强调在急诊医学中管胸切除术后对出血的警的重要性.
主要方法:
- 一份病例报告显示,一名58岁的男性患有酒精性肝硬化,出现了自发性血肺胸.
- 通过胸部计算机断层扫描诊断出血肺胸部.
- 导管胸膜切除术后,胸壁持续出血,需要导管切除和输血.
- 用对比增强的计算机断层扫描和血管造影来确定出血的来源.
主要成果:
- 管胸切除术后持续的胸壁出血.
- 从胸脊动脉中发现的对比外流.
- 胸脊动脉损伤的诊断得到确认.
- 胸脊动脉为"安全三角形"内的前肌提供分支.
结论:
- 在"安全三角"中放置胸腔管并不是完全没有血管损伤的风险.
- 胸脊动脉损伤是管胸切除术后显著出血的潜在原因.
- 紧急医生应保持对出血并发症的高度怀疑指数,并在术后密切监测患者.
更多相关视频
11:07A Murine Model of Myocardial Ischemia-reperfusion Injury through Ligation of the Left Anterior Descending Artery
Published on: April 10, 2014
39.6K
08:50Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
11.7K
相关概念视频
Pneumothorax-II
192
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
192
Pneumothorax-I
249
A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
249
Tracheostomy: Procedure and Tubes
711
A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
711
Thoracic Aorta
539
The thoracic section of the aorta begins at the T5 vertebra and extends to the T12 level at the diaphragm, initially progressing through the mediastinum to the left of the spinal column. Throughout its course in the thoracic segment, the thoracic aorta emits various offshoots known collectively as visceral and parietal branches. The branches that predominantly supply blood to visceral organs are termed visceral branches and include bronchial, pericardial, esophageal, and mediastinal arteries,...
539
Endoscopic Studies II: Thoracocentesis
323
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
323
Tracheostomy Decannulation
232
Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
232
