Obstructive shock induced by internal thoracic artery injury with traumatic sternal fracture

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2024-07-01 DOI:10.4103/tjem.tjem_253_23

Halleluyah Konno, Masakazu Nitta, Norihiro Watanabe, Mitsuyuki Miyazato, Akane Horiuchi

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Abstract

Internal thoracic artery (ITA) injuries associated with sternal fractures can lead to shock. Several studies have documented injuries resulting in hemorrhagic shock, yet there is limited reporting on obstructive shock. Opinions differ regarding which is superior between transcatheter arterial embolization (TAE) and open thoracotomy. We report the case of an 80-year-old female patient presented with blunt chest trauma when driving. Her vital signs were normal. However, ultrasonography revealed a hypoechoic anterior mediastinal lesion. Her blood pressure decreased immediately before undergoing a computed tomography (CT) scan. The CT scan showed a sternal fracture, anterior mediastinal extravasation, and dilation of the inferior vena cava. TAE was performed on both internal thoracic arteries, and the patient was transferred to a hospital where an open thoracotomy could be performed. The patient was treated conservatively and discharged without sequelae. Obstructive shock caused by an ITA injury with a sternal fracture can be successfully treated using TAE.

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胸内动脉损伤合并创伤性胸骨骨折引发的阻塞性休克

与胸骨骨折相关的胸内动脉（ITA）损伤可导致休克。有几项研究记录了导致失血性休克的损伤，但有关阻塞性休克的报道却很有限。关于经导管动脉栓塞术（TAE）和开胸手术孰优孰劣，众说纷纭。我们报告了一例 80 岁女性患者的病例。她的生命体征正常。然而，超声波检查发现前纵隔病变呈低回声。在接受计算机断层扫描（CT）前，她的血压立即下降。CT 扫描显示胸骨骨折、前纵隔外渗和下腔静脉扩张。医生对两根胸内动脉进行了TAE手术，并将患者转到可以进行开胸手术的医院。患者经保守治疗后出院，未留下后遗症。胸骨骨折导致的ITA损伤引起的阻塞性休克可以通过TAE成功治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.