Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Elkbuli, Adel, Shaikh, Saamia, Ehrhardt, John D., McKenney, Mark, Boneva, Dessy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2020
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
_version_ 1783508260153720832
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
work_keys_str_mv AT elkbuliadel superficialstabwoundtozoneioftheneckresultinginthyrocervicaltrunkpseudoaneurysmpresentedasrecurrenthemothoraxandsuccessfullymanagedbycoilembolization
AT shaikhsaamia superficialstabwoundtozoneioftheneckresultinginthyrocervicaltrunkpseudoaneurysmpresentedasrecurrenthemothoraxandsuccessfullymanagedbycoilembolization
AT ehrhardtjohnd superficialstabwoundtozoneioftheneckresultinginthyrocervicaltrunkpseudoaneurysmpresentedasrecurrenthemothoraxandsuccessfullymanagedbycoilembolization
AT mckenneymark superficialstabwoundtozoneioftheneckresultinginthyrocervicaltrunkpseudoaneurysmpresentedasrecurrenthemothoraxandsuccessfullymanagedbycoilembolization
AT bonevadessy superficialstabwoundtozoneioftheneckresultinginthyrocervicaltrunkpseudoaneurysmpresentedasrecurrenthemothoraxandsuccessfullymanagedbycoilembolization