[A case report of the subclavian pseudoaneurysm due to blunt chest trauma without fracture].

Abstract

A young adult patient, 21 years old female, with left subclavian pseudoanurysm caused by blunt chest trauma is reported. The patient was carried to the emergency room of our hospital with the blunt trauma and lung contusion due to the traffic accident. On chest roentgenogram no fractures of ribs and subclavia were seen, but the superior mediastinum was widened. Superior mediastinal hematoma was suspected by CT scan. Following examination of aortogram revealed an pseudoaneurysm of the left subclavian artery at the origin of left internal artery. Emergency operation was performed with left postero-lateral thoracotomy and the aneurysm was located just the point at the bifurcation of internal mammary from left subclavian artery. Internal mammary artery was clipped and the fissure of the subclavian of the subclavian artery was repaired by direct suture under temporary occlusion of the subclavian artery. Postoperative course was uneventful and superior mediastinal hematoma was not noticed on chest roentgenogram and CT of 18 days postoperatively.