2021, Number 4
Gunshot wound with lung injury, brachial plexus, axillary and intercostal artery
Language: Spanish
References: 13
Page:
PDF size: 202.33 Kb.
ABSTRACT
Introduction: Chest traumas with associated vascular lesions worsen the prognosis of patients due to hemorrhage. 80 % of all vascular traumas affect the extremities and 30 % are located in the upper limbs. Being able to use the patient's own tissues for repair is a viable treatment alternative, and sometimes the only possible one.Objective: To present a patient with chest trauma with vascular lesions, where the saphenous vein was used to restore the damage in the axillary artery and the tractotomy technique for massive hemothorax with lesion of the lung parenchyma.
Clinical case: 32-year-old male patient with a gunshot wound to the shoulder and right hemithorax, which caused injury to the right axillary artery and massive hemothorax. A thoracotomy with tractotomy was performed at the level of the right upper lobe and ligation of the intercostal artery; and the right axillary region was explored to repair vascular damage.
Conclusions: To treat penetrating chest trauma with bleeding lung injury, a pulmonary tractotomy and hemostasis should be performed to avoid intraparenchymal hematomas. Faced with an irreparable axillary artery injury, the saphenous vein is a viable alternative for its restoration and to achieve the vitality of the limb.
REFERENCES
Chang SW, Ryu KM, Ryu JW. Delayed massive hemothorax requiring surgery after blunt thoracic trauma over a 5-year period: complicating rib fracture with sharp edge associated with diaphragm injury. Clin Exp Emerg Med. 2018 [acceso: 13/03/2021];5(1):60-65. Disponible en: https://doi.org/10.15441/ceem.16.190
Chiarelli M, Gerosa M, Guttadauro A, Gabrielli F, Vertemati G, Cazzaniga M, Fumagalli L, et al. Urgent pulmonary lobectomy for blunt chest trauma: report of three cases without mortality. Journal of thoracic disease. 2016 [acceso: 14/03/2021]; 8(7):1825. Disponible en: http://dx.doi.org/10.21037/jtd.2016.06.10
Valdés O, Alvia G, González J, Jalil J, Bazurto A, Roldan N. Revascularización de arteria humeral con vena safena invertida, en traumatismo vascular por arma blanca. Revista Cubana de Medicina Militar. 2021 [acceso: 07/03/2021]; 50(1): e0210722. Disponible en:Disponible en:http://www.revmedmilitar.sld.cu/index.php/mil/article/view/722