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ID 61030
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Iida, Atsuyoshi Department of Emergency Medicine, Okayama Red Cross Hospital
Nishida, Ayumi epartment of Neurosurgery, Okayama Red Cross Hospital
Yoshitomi, Seiji Department of Breast and Endocrine Surgery, Okayama Red Cross Hospital
Nojima, Tsuyoshi Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences ORCID Kaken ID publons researchmap
Naito, Hiromichi Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences ORCID Kaken ID publons
Nakao, Atsunori Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kaken ID
Abstract
Introduction
Blunt neck trauma patients can suffer from an airway emergency and are necessary to careful observation.
Presentation of cas
e A 79-year-old man under anticoagulation therapy presented to our hospital three hours after a fall. Shortly after arrival, he developed dyspnea. Oral intubation was attempted, but with no success; therefore, an emergency tracheotomy was performed. Contrast-enhanced computed tomography (CT) and subsequent angiography revealed active bleeding from a branch of the right ascending cervical artery. Subsequently, the right thyrocervical trunk, which is upstream from the ascending cervical artery, was embolized and hemostasis was achieved. He was discharged 52 days after the emergency admission.
Discussion
This is the first case report of an ascending cervical artery injury due to blunt trauma that resulted in an airway emergency. Contrast-enhanced CT and cervical angiography are useful for confirming the area of injury and size of the hematoma. Half of patients with respiratory distress accompanied by a cervical spine injury require definitive airway management within five hours of the injury and all by 24 h. Neck trauma can lead to fatal airway obstruction and careful monitoring is warranted to detect any signs of impeding respiratory obstruction.
Conclusion
All emergency physicians need to keep their airway management skills updated in order to perform reliably and rapidly in difficult and urgent situations.
Keywords
Airway management
Ascending cervical artery
Emergency tracheostomy
Thyrocervical trunk
Vascular embolization
Published Date
2020
Publication Title
International Journal of Surgery Case Reports
Volume
volume77
Publisher
Elsevier
Start Page
321
End Page
324
ISSN
2210-2612
Content Type
Journal Article
language
英語
OAI-PMH Set
岡山大学
Copyright Holders
© 2020 The Authors.
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publisher
PubMed ID
DOI
Related Url
isVersionOf https://doi.org/10.1016/j.ijscr.2020.11.007
License
http://creativecommons.org/licenses/by-nc-nd/4.0/