一例颈部穿透性损伤（位于 II 区），采用血管内治疗和外科治疗相结合的方法进行治疗

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL Acute Medicine & Surgery Pub Date : 2024-11-14 DOI:10.1002/ams2.70022

Youhei Nakamura, Shunichiro Nakao, Takeshi Nishida, Hiroshi Ito, Tomohiko Ozaki, Jun Oda

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引用次数: 0

摘要

背景我们报告了一例 II 区穿透性颈部创伤伴活动性出血的病例，该病例在颈部探查前进行了血管内治疗，以确定并控制出血点。病例介绍一名 50 多岁的男子因右侧颈部穿透性刀伤导致失血性休克而到我院急诊科就诊。他的右颈部伤口和口腔大量出血。颈部血管造影显示右颈外动脉出血，右颈内动脉内膜损伤。在颈总动脉源头和受伤的颈内动脉远端进行了球囊闭塞，控制了活动性出血。在血管球囊闭塞期间，通过结扎近端颈外动脉实现了最终止血治疗。结论颈部探查结合血管内治疗可能是 II 区颈部穿透性损伤患者的治疗策略之一。

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A case of penetrating neck injury in zone II treated with combined endovascular and surgical management

Background

We report a case of zone II penetrating neck trauma with active bleeding in which endovascular treatment was performed prior to neck exploration to identify and control the bleeding point.

Case Presentation

A man in his 50s presented to our emergency department in hemorrhagic shock stemming from a penetrating knife wound injury to the right side of his neck. He was bleeding massively from the right neck wound and oral cavity. Cervical angiography showed bleeding from the right external carotid artery and intimal injury to the right internal carotid artery. Balloon occlusion at the common carotid artery origin and distal to the injured internal carotid artery controlled active bleeding. During vascular balloon occlusion, definitive hemostatic treatment was achieved through ligation of the proximal external carotid artery.