骨盆外伤中髂内外动脉检查的重要性:双侧尸冠出血伴单侧髂外动脉异常

M. Herskowitz, J. Walsh, M. Lilly, K. McFarland
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引用次数: 5

摘要

经导管血管造影和栓塞术一直被认为是治疗钝性骨盆创伤后血流动力学不稳定的金标准。虽然通常根据术前ct血管造影的外渗分布可以很容易地定位出血源,但在评估异常解剖结构时应谨慎。一种起源于髂外动脉腹壁下支的变异闭孔动脉通常被称为尸冠动脉。我们提出一个钝性骨盆创伤的情况下,病人表现出外渗在两个髂内动脉的前分布。在双侧髂内动脉栓塞后,确定和栓塞双侧尸冠分支对于实现该患者的血流动力学稳定至关重要。
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Importance of Both Internal and External Iliac Artery Interrogation in Pelvic Trauma as Evidenced by Hemorrhage from Bilateral Corona Mortis with Unilateral Aberrant Origin off the External Iliac Artery
Transcatheter angiography and embolization has long been recognized as the gold standard for patients with hemodynamic instability secondary to blunt pelvic trauma. While often the bleeding source can be readily localized based on the distribution of extravasation on preprocedural Computed Tomographic Angiography, one should be cautious in assessment for aberrant anatomy. A variant obturator artery originating from the inferior epigastric branch of the external iliac artery is commonly referred to as the corona mortis. We present a case of blunt pelvic trauma in which a patient demonstrated extravasation in the anterior distributions of both internal iliac arteries. Following embolization of bilateral internal iliac arteries, identification and embolization of bilateral corona mortis branches was crucial to achieving hemodynamic stability in this patient.
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