Arterial injuries and their management

Slaney, G; Ashton, F.

doi:10.1136/pgmj.47.547.257

Cited by 14 publications

(1 citation statement)

References 30 publications

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“…However with the institution of arterial repair, this rate was considerably reduced. [1] DeBakey et al in 1946 found that arterial injuries resulted in an amputation rate of nearly 75%. [2] Concluding on a depressing note they wrote that 'no procedure other than ligation is applicable to a majority of vascular injuries'.…”

Section: Introductionmentioning

confidence: 99%

Pattern, Management, Results And Complications Of Vascular Injuries Of The Extremities. Report From A Hospital In Jammu

2010

IJOS

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Section: Introductionmentioning

confidence: 99%

Pattern, Management, Results And Complications Of Vascular Injuries Of The Extremities. Report From A Hospital In Jammu

2010

IJOS

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Management of acute brachial artery occlusion due to trauma or emboli

Lambert

Ball

Hancock

1983

Journal of British Surgery

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Out of 37 patients requiring emergency surgery for upper limb ischaemia, 9 were due to spontaneous embolus, 7 to arterial laceration and 21 followed cardiac catheterization. Eleven of the initial operations (30 per cent) failed to relieve ischaemic symptoms though 6 were corrected by further operations. Success at the initial operation was associated with (i) repair with end‐to‐end anastomosis after resection, saphenous vein bypass or interposition graft, or generous vein patch, (ii) exposure of the radial/ulnar bifurcation, (iii) instillation of heparinized saline locally or (iv) restoration of the radial pulse at the end of the operation. In the cases studied in whom all the above recommendations were followed, the operation was entirely successful and all patients have a radial pulse and are currently symptom free.

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Seat-belt aorta: Isolated abdominal aortic injury following blunt trauma

Clyne

Ashbrooke

1985

Journal of British Surgery

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Correspondence to: Mr C. A. C. Clyne, Torbay Hospital, Lawes Bridge, Torquay, Devon TQ2 7AA, UK As health education promoting the use of seat-belts did not increase the rate of wearing of belts by front seat passengers above 35 per cent', seat-belt wearing became law in the UK on 31 January 1983. This legislation reduced deaths and serious injuries to front seat passengers by 25 per cent', but has caused an increase in spinal injuries and may well lead to an increase in blunt trauma to the chest and abdomen from the seat belts themselves3. This paper reports a case of seat-belt injury to the abdominal aorta following a road traffic accident. Case reportA 54-year-old man presented to the casualty department within an hour of having driven his van into the back of a lorry. He was wearing a lap and diagonal inertia seat-belt and was travelling at only 28-30 m.p.h. at the time of the accident. After the impact he began to walk home. After 200 yards both his legs became numb and weak and he was forced to rest, during which time the power and sensation returned in his right leg only.His past history included a left lumbar sympathectomy at the age of 25 following calf trauma, and a laminectomy following disc protrusion at the age of 44 years. He was a lifelong smoker but had never experienced angina or intermittent claudication.On admission he was hypertensive (BP 210/110). There was a small cut on his lower lip but no thoracic or abdominal tenderness or bruising.All pulses in the upper limbs were normal and equal but between being seen by the casualty officer and the surgical SHO, the left leg pulses disappeared, the right leg pulses being present but reduced. The left leg was also totally insensitive to pin-prick from the inguinal ligament downwards, and there was no motor power below and including the left hip flexor muscles. A diagnosis of aortic or iliac dissection was made and he was taken to theatre approximately 5 h after the accident. Plain Xrays of the abdomen and chest had revealed no abnormality and an arteriogram was not undertaken. He was explored through a transverse abdominal incision after exploration of the left femoral artery revealed no downflow and Fogarty catheterization had failed to produce any clot. The only organ found to be damaged was the aorta which was bruised from below the kidneys and a small retroperitoneal haematoma had formed, extending to the bifurcation of both common iliacs. Aortotomy revealed the lower 6-7 cm of aorta contained thrombus, a circumferential flap of intima having been dissected off the remaining wall of the aorta. The dissection appeared to end at both common iliac bifurcations. Aorto-iliac endarterectomy was attempted with an unsatisfactory result so the aorta was transected and a Dacron trouser graft inserted to the right external iliac artery just beyond the bifurcation and the left common femoral artery.Following surgery the patient did well and regained all his pulses. Two weeks later, further laparotomy was necessary for small bowel adhesion obstruction from ...

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Arterial injuries and their management

Cited by 14 publications

References 30 publications

Pattern, Management, Results And Complications Of Vascular Injuries Of The Extremities. Report From A Hospital In Jammu

Pattern, Management, Results And Complications Of Vascular Injuries Of The Extremities. Report From A Hospital In Jammu

Management of acute brachial artery occlusion due to trauma or emboli

Seat-belt aorta: Isolated abdominal aortic injury following blunt trauma

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