Massive haemothorax and haemorrhagic shock due to cervical vascular injury caused by a seat belt.
Tomoya NishinoAsuka TsuchiyaSeiji MoritaYoshihide NakagawaPublished in: BMJ case reports (2023)
A woman in her 50s was transported to our hospital after experiencing a road traffic crash that led to a massive haemothorax and haemorrhagic shock due to a cervical vascular injury caused by the seat belt. Contrast-enhanced CT of the chest showed extravascular leakage of the contrast medium from the vicinity of the right subclavicular area and fluid accumulation in the thoracic cavity. The patient was intubated, and a thoracic drainage catheter was placed. She underwent angiography and embolisation of the right costocervical trunk, right thyrocervical trunk and right suprascapular artery using a gelatine sponge and 25% N -butylcyanoacrylate-Lipiodol. She was extubated on the second day after stabilisation of the respiratory and circulatory status. In cases where the bleeding vessel is known and an emergency thoracotomy can serve as a backup, embolisation by interventional radiology should be considered the initial treatment approach.
Keyphrases
- contrast enhanced
- computed tomography
- diffusion weighted
- magnetic resonance imaging
- magnetic resonance
- spinal cord
- diffusion weighted imaging
- case report
- healthcare
- dual energy
- ultrasound guided
- emergency department
- lower limb
- public health
- optical coherence tomography
- artificial intelligence
- air pollution
- positron emission tomography
- extracorporeal membrane oxygenation
- atrial fibrillation
- heart failure
- image quality
- aortic valve replacement
- spinal cord injury
- coronary artery disease
- respiratory tract