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Published in: Journal of Medical Case Reports 1/2012

Open Access 01-12-2012 | Case report

Traumatic intercostal arterial bleeding controlled with a novel surgical technique: a case report

Authors: Simo Miettinen, Tapio Hakala

Published in: Journal of Medical Case Reports | Issue 1/2012

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Abstract

Introduction

A blunt thoracic trauma may cause arterial bleeding requiring operative treatment or endovascular embolization or endovascular aortic stenting. A novel damage control technique to stop such bleeding is presented.

Case presentation

We present the case of an 82-year-old Caucasian man who experienced rib fractures I-VII on the left side and bleeding from damaged intercostal arteries after a blunt thoracic trauma. Emergency thoracotomy was performed.

Conclusions

Effective hemostasis was achieved by using a rolled surgical swab and inserting it against the chest wall next to the aorta with sutures pulled through the intercostal muscles and then sutured to the back side of the patient. The patient died four days after the surgery due to a head injury sustained in the car crash.
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Literature
2.
go back to reference Laszlo K, Schreiber M: Management of the crushed chest. Crit Care Med. 2010, 38: 469-477.CrossRef Laszlo K, Schreiber M: Management of the crushed chest. Crit Care Med. 2010, 38: 469-477.CrossRef
3.
go back to reference O´Connor JVO, Byrne C, Scalea TM, Griffith BP, Neschis DG: Vascular injuries after blunt chest trauma: diagnosis and management. Scand J Trauma Resusc Emerg Med. 2009, 17: 42-10.1186/1757-7241-17-42.CrossRef O´Connor JVO, Byrne C, Scalea TM, Griffith BP, Neschis DG: Vascular injuries after blunt chest trauma: diagnosis and management. Scand J Trauma Resusc Emerg Med. 2009, 17: 42-10.1186/1757-7241-17-42.CrossRef
4.
go back to reference Töpel I, Steinbauer M, Paetzel C, Kasprzak PM: Endovascular therapy of a ruptured intercostal artery aneurysm. J Endovac Ther. 2004, 11: 219-221. 10.1583/03-1137.1.CrossRef Töpel I, Steinbauer M, Paetzel C, Kasprzak PM: Endovascular therapy of a ruptured intercostal artery aneurysm. J Endovac Ther. 2004, 11: 219-221. 10.1583/03-1137.1.CrossRef
5.
go back to reference Hagiwara A, Yanagawa Y, Kaneko N, Takasu A, Hatanak K, Sakamoto T, Okada Y: Indications for transcatheter arterial embolization in persistent hemothorax. J Trauma. 2008, 65: 589-594. 10.1097/TA.0b013e318181d56a.CrossRefPubMed Hagiwara A, Yanagawa Y, Kaneko N, Takasu A, Hatanak K, Sakamoto T, Okada Y: Indications for transcatheter arterial embolization in persistent hemothorax. J Trauma. 2008, 65: 589-594. 10.1097/TA.0b013e318181d56a.CrossRefPubMed
6.
go back to reference Chemelli AP, Thauerer M, Wiedermaan F, Strasak A, Klocker J, Chemelli-Steinruber IE: Transcatheter arterial embolization for the management of iatrogenic and blunt traumatic intercostal artery injuries. J Vasc Surg. 2009, 49: 1505-1512. 10.1016/j.jvs.2009.02.001.CrossRefPubMed Chemelli AP, Thauerer M, Wiedermaan F, Strasak A, Klocker J, Chemelli-Steinruber IE: Transcatheter arterial embolization for the management of iatrogenic and blunt traumatic intercostal artery injuries. J Vasc Surg. 2009, 49: 1505-1512. 10.1016/j.jvs.2009.02.001.CrossRefPubMed
7.
go back to reference Hirshberg A, Mattox K: Top Knife. The Art & Craft Of Trauma Surgery. 2005, tfm Publishing Ltd, Castle Hill Barns, Harley, Nr Shrewsbury, UK, 171-174. Hirshberg A, Mattox K: Top Knife. The Art & Craft Of Trauma Surgery. 2005, tfm Publishing Ltd, Castle Hill Barns, Harley, Nr Shrewsbury, UK, 171-174.
8.
go back to reference Carillo EH, Heniford BT, Senler SO, Sykes JR, Maniscalco SP, Richarson JD: Embolization therapy as an alternative to thoracotomy in vascular injuries of the chest wall. Am Surg. 1998, 64: 1142-1148. Carillo EH, Heniford BT, Senler SO, Sykes JR, Maniscalco SP, Richarson JD: Embolization therapy as an alternative to thoracotomy in vascular injuries of the chest wall. Am Surg. 1998, 64: 1142-1148.
Metadata
Title
Traumatic intercostal arterial bleeding controlled with a novel surgical technique: a case report
Authors
Simo Miettinen
Tapio Hakala
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2012
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-6-318

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