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Superficial Stab Wound to Zone I of the Neck Resulting in Thyrocervical Trunk Pseudoaneurysm Presented as Recurrent Hemothorax and Successfully Managed by Coil Embolization
Patient: Male, 27-year-old Final Diagnosis: Thyrocervical trunk pseudoaneurysm with recurrent hemothorax Symptoms: Diaphoresis • lethargy Medication: — Clinical Procedure: Coil embolization Specialty: Surgery OBJECTIVE: Rare disease BACKGROUND: Thyrocervical trunk pseudoaneurysms are rare complicati...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Scientific Literature, Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081952/ https://www.ncbi.nlm.nih.gov/pubmed/32146480 http://dx.doi.org/10.12659/AJCR.920196 |
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author | Elkbuli, Adel Shaikh, Saamia Ehrhardt, John D. McKenney, Mark Boneva, Dessy |
author_facet | Elkbuli, Adel Shaikh, Saamia Ehrhardt, John D. McKenney, Mark Boneva, Dessy |
author_sort | Elkbuli, Adel |
collection | PubMed |
description | Patient: Male, 27-year-old Final Diagnosis: Thyrocervical trunk pseudoaneurysm with recurrent hemothorax Symptoms: Diaphoresis • lethargy Medication: — Clinical Procedure: Coil embolization Specialty: Surgery OBJECTIVE: Rare disease BACKGROUND: Thyrocervical trunk pseudoaneurysms are rare complications that have been documented after internal jugular or subclavian venous cannulation. Even less common, these pseudoaneurysms can arise after blunt or penetrating trauma. Clinical hallmarks include an expanding supraclavicular mass with local compressive symptoms such as paresthesias, arterial steal syndrome, and Horner’s syndrome. Patients may be asymptomatic, however, or present with overlying ecchymosis or the presence of a new bruit or thrill. With the risk of rupture, thyrocervical trunk pseudoaneurysm is associated with significant morbidity and mortality. CASE REPORT: We report the case of a 27-year-old man who presented after sustaining a self-inflicted stab wound to zone I of his neck. Initial examination revealed only a superficial small laceration, but a chest x-ray revealed a pneumothorax, and tube thoracostomy returned 300 mL of bloody output. After resolution of the hemothorax and removal of the thoracostomy tube, the patient reaccumulated blood, requiring a repeat tube thoracostomy. Angiography at that time revealed a pseudoaneurysm of the thyrocervical trunk, and coil embolization was performed to obliterate the pseudoaneurysm. CONCLUSIONS: Thyrocervical trunk pseudoaneurysms can be asymptomatic, often have a delayed presentation, and can be life-threatening due to the risk of rupture and subsequent hemodynamic decline or airway compromise. While these pseudoaneurysms are well-known complications of deep penetrating injuries, they can also present following superficial penetrating injury to zone I of the neck. Selective angiography is the imaging modality of choice. Open surgical repair was traditionally the criterion standard for treatment; however, endovascular approaches are minimally invasive, feasible, and safer alternatives with reduced complications and are becoming more common. |
format | Online Article Text |
id | pubmed-7081952 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | International Scientific Literature, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-70819522020-03-25 Superficial Stab Wound to Zone I of the Neck Resulting in Thyrocervical Trunk Pseudoaneurysm Presented as Recurrent Hemothorax and Successfully Managed by Coil Embolization Elkbuli, Adel Shaikh, Saamia Ehrhardt, John D. McKenney, Mark Boneva, Dessy Am J Case Rep Articles Patient: Male, 27-year-old Final Diagnosis: Thyrocervical trunk pseudoaneurysm with recurrent hemothorax Symptoms: Diaphoresis • lethargy Medication: — Clinical Procedure: Coil embolization Specialty: Surgery OBJECTIVE: Rare disease BACKGROUND: Thyrocervical trunk pseudoaneurysms are rare complications that have been documented after internal jugular or subclavian venous cannulation. Even less common, these pseudoaneurysms can arise after blunt or penetrating trauma. Clinical hallmarks include an expanding supraclavicular mass with local compressive symptoms such as paresthesias, arterial steal syndrome, and Horner’s syndrome. Patients may be asymptomatic, however, or present with overlying ecchymosis or the presence of a new bruit or thrill. With the risk of rupture, thyrocervical trunk pseudoaneurysm is associated with significant morbidity and mortality. CASE REPORT: We report the case of a 27-year-old man who presented after sustaining a self-inflicted stab wound to zone I of his neck. Initial examination revealed only a superficial small laceration, but a chest x-ray revealed a pneumothorax, and tube thoracostomy returned 300 mL of bloody output. After resolution of the hemothorax and removal of the thoracostomy tube, the patient reaccumulated blood, requiring a repeat tube thoracostomy. Angiography at that time revealed a pseudoaneurysm of the thyrocervical trunk, and coil embolization was performed to obliterate the pseudoaneurysm. CONCLUSIONS: Thyrocervical trunk pseudoaneurysms can be asymptomatic, often have a delayed presentation, and can be life-threatening due to the risk of rupture and subsequent hemodynamic decline or airway compromise. While these pseudoaneurysms are well-known complications of deep penetrating injuries, they can also present following superficial penetrating injury to zone I of the neck. Selective angiography is the imaging modality of choice. Open surgical repair was traditionally the criterion standard for treatment; however, endovascular approaches are minimally invasive, feasible, and safer alternatives with reduced complications and are becoming more common. International Scientific Literature, Inc. 2020-03-08 /pmc/articles/PMC7081952/ /pubmed/32146480 http://dx.doi.org/10.12659/AJCR.920196 Text en © Am J Case Rep, 2020 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) ) |
spellingShingle | Articles Elkbuli, Adel Shaikh, Saamia Ehrhardt, John D. McKenney, Mark Boneva, Dessy Superficial Stab Wound to Zone I of the Neck Resulting in Thyrocervical Trunk Pseudoaneurysm Presented as Recurrent Hemothorax and Successfully Managed by Coil Embolization |
title | Superficial Stab Wound to Zone I of the Neck Resulting in Thyrocervical Trunk Pseudoaneurysm Presented as Recurrent Hemothorax and Successfully Managed by Coil Embolization |
title_full | Superficial Stab Wound to Zone I of the Neck Resulting in Thyrocervical Trunk Pseudoaneurysm Presented as Recurrent Hemothorax and Successfully Managed by Coil Embolization |
title_fullStr | Superficial Stab Wound to Zone I of the Neck Resulting in Thyrocervical Trunk Pseudoaneurysm Presented as Recurrent Hemothorax and Successfully Managed by Coil Embolization |
title_full_unstemmed | Superficial Stab Wound to Zone I of the Neck Resulting in Thyrocervical Trunk Pseudoaneurysm Presented as Recurrent Hemothorax and Successfully Managed by Coil Embolization |
title_short | Superficial Stab Wound to Zone I of the Neck Resulting in Thyrocervical Trunk Pseudoaneurysm Presented as Recurrent Hemothorax and Successfully Managed by Coil Embolization |
title_sort | superficial stab wound to zone i of the neck resulting in thyrocervical trunk pseudoaneurysm presented as recurrent hemothorax and successfully managed by coil embolization |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081952/ https://www.ncbi.nlm.nih.gov/pubmed/32146480 http://dx.doi.org/10.12659/AJCR.920196 |
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