ID | 61030 |
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Author |
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
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Naito, Hiromichi
Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
ORCID
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Nakao, Atsunori
Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Abstract | Introduction
Blunt neck trauma patients can suffer from an airway emergency and are necessary to careful observation.
Presentation of case
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.
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Keywords | Airway management
Ascending cervical artery
Emergency tracheostomy
Thyrocervical trunk
Vascular embolization
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Published Date | 2020
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Publication Title |
International Journal of Surgery Case Reports
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Volume | volume77
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Publisher | Elsevier
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Start Page | 321
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End Page | 324
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ISSN | 2210-2612
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Content Type |
Journal Article
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language |
English
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OAI-PMH Set |
岡山大学
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Copyright Holders | © 2020 The Authors.
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File Version | publisher
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PubMed ID | |
DOI | |
Related Url | isVersionOf https://doi.org/10.1016/j.ijscr.2020.11.007
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License | http://creativecommons.org/licenses/by-nc-nd/4.0/
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