Blunt transverse cervical artery injury required operative management

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  • 鈍的外傷による頸横動脈損傷に対して外科的止血術を施行した1例

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Abstract

Transverse cervical artery, a branch of thyrocervical trunk injury is rare. A 70-year-old man was transferred to our emergency department 2 hours and 30 minutes after his car crashed into a guardrail. On admission, seatbelt sign and a fist-sized hematoma around the right clavicle were detected, and his trachea was deviated due to compression by the hematoma. An enhanced computed tomography （CT） revealed a large hematoma with extravasation. We selected operative management. The hematoma was exposed through the anterior border of the sternocleidomastoid muscle and supraclavicular skin incision. We detected transverse cervical artery injury and ligated it. He was extubated on the same day as the operation. Active bleeding of neck arterial injury needs prompt airway management and appropriate hemostasis. The procedure should be based on the complexity of the vascular injury, associated injuries, the patientʼs clinical status, and the availability of appropriately trained interventional radiology staff.

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