초록접수 현황
| 16F-054 | 포스터 발표 |
Surgical Treatment of Abdominal Aorta Occlusion after Blunt Trauma
Chun Sung Byun, Il Hwan Park, Soonchang Hong, Joong Hwan Oh
Department of Throacic and Cardiovascular Surgery, Wonju Severance Christian Hospital, Yonsei University College of Medicine, Gangwon-do, Korea
Background : Blunt traumatic abdominal aorta occlusion is extremely rare and potentially critical. When such injury results in the occlusion of the aorta itself or of one of the common iliac arteries, the presentation is dramatic. We present the 3 cases involved in a frontal car crash or direct low abdominal blow result infra-renal abdominal aorta.²
Methods : All patients present with absent femoral and distal pulses in association with lower extremity neuropathy. Diagnosis was suspected on clinical grounds and confirmed with CT scanning. Duration of occlusion interval was 5 hours in 1 patient, and 9 hours in 2 patients. After abdominal aortic bypass surgery, rhabdomyolysis proceeded in 2 patients of 9 hours occlusion duration. And these two patients were died from uncorrectable metabolic acidosis under CRRT and multi-organ failure. Another one patients discharged with good motor and neurologic status.
Results : Complete vessel occlusion after blunt trauma to the abdominal aorta is rare. The most frequent mechanism identified is compression from a seat belt or steering wheel during a motor vehicle crash. Coexisting intra-abdominal injury requiring repair is often seen. In most cases, intimal tears with or without subintimal thrombosis account for the luminal obstruction. Preexisting intimal and subintimal aortic abnormality is typical.
Conclusion : In our cases of blunt traumatic abdominal aorta occlusion, early repair of this injury show the best chance for limb salvage and full neurologic recovery.
Methods : All patients present with absent femoral and distal pulses in association with lower extremity neuropathy. Diagnosis was suspected on clinical grounds and confirmed with CT scanning. Duration of occlusion interval was 5 hours in 1 patient, and 9 hours in 2 patients. After abdominal aortic bypass surgery, rhabdomyolysis proceeded in 2 patients of 9 hours occlusion duration. And these two patients were died from uncorrectable metabolic acidosis under CRRT and multi-organ failure. Another one patients discharged with good motor and neurologic status.
Results : Complete vessel occlusion after blunt trauma to the abdominal aorta is rare. The most frequent mechanism identified is compression from a seat belt or steering wheel during a motor vehicle crash. Coexisting intra-abdominal injury requiring repair is often seen. In most cases, intimal tears with or without subintimal thrombosis account for the luminal obstruction. Preexisting intimal and subintimal aortic abnormality is typical.
Conclusion : In our cases of blunt traumatic abdominal aorta occlusion, early repair of this injury show the best chance for limb salvage and full neurologic recovery.
책임저자: Joong Hwan Oh
Department of Throacic and Cardiovascular Surgery, Wonju Severance Christian Hospital, Yonsei University College of Medicine, Gangwon-do, Korea
발표자: Chun Sung Byun, E-mail : csbyun@yonsei.ac.kr