Abdominal Vascular Injuries
Although their incidence is rare, successful management of injuries to the abdominal aorta and its main branches is a challenge to both trauma surgeons and vascular surgeons. Early diagnosis is extremely important and surgical exploration should be performed without delay. A thorough knowledge of th...
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| Published in | Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 24; no. 5; pp. 899 - 905 |
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| Main Authors | , , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japanese Society for Abdominal Emergency Medicine
2004
日本腹部救急医学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1340-2242 1882-4781 |
| DOI | 10.11231/jaem1993.24.899 |
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| Abstract | Although their incidence is rare, successful management of injuries to the abdominal aorta and its main branches is a challenge to both trauma surgeons and vascular surgeons. Early diagnosis is extremely important and surgical exploration should be performed without delay. A thorough knowledge of the abdominal vascular anatomy and techniques of vascular repair are indispensable together with the concept of damage control surgery, the principle of abbreviated laparotomy with planned reoperation. The primary goal in the management of these patients should be hemorrhage control rather than maintenance of blood flow to save their lives. |
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| AbstractList | Although their incidence is rare, successful management of injuries to the abdominal aorta and its main branches is a challenge to both trauma surgeons and vascular surgeons. Early diagnosis is extremely important and surgical exploration should be performed without delay. A thorough knowledge of the abdominal vascular anatomy and techniques of vascular repair are indispensable together with the concept of damage control surgery, the principle of abbreviated laparotomy with planned reoperation. The primary goal in the management of these patients should be hemorrhage control rather than maintenance of blood flow to save their lives.
腹部大動脈領域の血管損傷はまれではあるが, 発生すると重篤な状態となるために, 早期診断が極めて重要となる. 損傷メカニズムを熟知し, その発生を常に念頭に置きながら患者を診察する. 治療には血管解剖の知識や血管外科的手技が不可欠であり, また, damage control surgeryの概念も理解していなけれぼならない. 診断がついたならば, 直達あるいは経動脈的に大動脈遮断を早期に行い, 出血をコントロールすることが救命のためのキーポイントである. Although their incidence is rare, successful management of injuries to the abdominal aorta and its main branches is a challenge to both trauma surgeons and vascular surgeons. Early diagnosis is extremely important and surgical exploration should be performed without delay. A thorough knowledge of the abdominal vascular anatomy and techniques of vascular repair are indispensable together with the concept of damage control surgery, the principle of abbreviated laparotomy with planned reoperation. The primary goal in the management of these patients should be hemorrhage control rather than maintenance of blood flow to save their lives. |
| Author | Miyata, Tetsuro Kondo, Keisuke Akagi, Daisukem Okamoto, Hiroyuki Miyahara, Takuya Hoshina, Katsuyuki Shigematsu, Kunihiro Yamamoto, Kota Saito, Takehito Hosaka, Akihiro Kanetaka, Takehito Nakazawa, Tatsu |
| Author_FL | 岡本 宏之 山本 晃太 保坂 晃弘 宮田 哲郎 宮原 拓也 中澤 達 重松 邦弘 保科 克行 赤木 大輔 兼高 武仁 齋藤 健人 近藤 啓介 |
| Author_FL_xml | – sequence: 1 fullname: 宮田 哲郎 – sequence: 2 fullname: 赤木 大輔 – sequence: 3 fullname: 山本 晃太 – sequence: 4 fullname: 保坂 晃弘 – sequence: 5 fullname: 宮原 拓也 – sequence: 6 fullname: 齋藤 健人 – sequence: 7 fullname: 兼高 武仁 – sequence: 8 fullname: 保科 克行 – sequence: 9 fullname: 近藤 啓介 – sequence: 10 fullname: 中澤 達 – sequence: 11 fullname: 岡本 宏之 – sequence: 12 fullname: 重松 邦弘 |
| Author_xml | – sequence: 1 fullname: Hoshina, Katsuyuki organization: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo – sequence: 1 fullname: Miyata, Tetsuro organization: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo – sequence: 1 fullname: Miyahara, Takuya organization: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo – sequence: 1 fullname: Akagi, Daisukem organization: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo – sequence: 1 fullname: Hosaka, Akihiro organization: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo – sequence: 1 fullname: Okamoto, Hiroyuki organization: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo – sequence: 1 fullname: Kanetaka, Takehito organization: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo – sequence: 1 fullname: Kondo, Keisuke organization: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo – sequence: 1 fullname: Shigematsu, Kunihiro organization: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo – sequence: 1 fullname: Nakazawa, Tatsu organization: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo – sequence: 1 fullname: Saito, Takehito organization: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo – sequence: 1 fullname: Yamamoto, Kota organization: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo |
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| PublicationTitle_FL | J Abdom Emerg Med 日本腹部救急医学会雑誌 日腹部救急医会誌 Journal of Abdominal Emergency Medicine Nihon Fukubu Kyukyu Igakkai Zasshi |
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| Publisher | Japanese Society for Abdominal Emergency Medicine 日本腹部救急医学会 |
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| References | 1) Carrillo EH, Bergamini TM, Miller FB, et al: Abdominal vascular injuries. J Trauma 1997; 43: 164-171. 23) 宮田哲郎: 腹部血管解剖. 宮田哲郎編, 一般外科医のための血管外科の要点と盲点. 第1版, 東京, 文光堂, 2001: 12-17. 15) Collins PS, Golocovsky M, Salander JM, et al: Intra-abdominal vascular injury secondary to penetrating trauma. J Trauma 1988; 28: S 165-170. 5) Chase CW, Layman TS, Barker DE, et al: Traumatic abdominal aortic pseudoaneurysm causing biliary obstruction: a case report and review of the literature. J Vasc Surg 1997; 25: 936-940. 8) Chaikof EL, Shamberger RC, Brewster DC: Traumatic pseudoaneurysms of the abdominal aorta. J Trauma 1985; 25: 169-173. 20) Richardson JD, Polk HC Jr: Reoperation for trauma. Ann Surg 1995; 222: 1-2. 10) Montero M, Tellado MG, Rios J, et al: Aortic injury during diagnostic pediatric laparoscopy. Surg Endosc 2001; 15: 519. 11) May J, Schulze K: Successful completion of endoluminal repair of an abdominal aortic aneurysm after intraoperative iatrogenic rupture of the aneurysm. J Vasc Surg 1999; 30: 901-906. 3) Lassonde J, Laurendeau F: Blunt injury of the abdominal aorta. Ann Surg 1981; 194: 745-748. 7) Siqueira TM Jr, Kuo RL, Gardner TA, et al: Major complications in 213 laparoscopic nephrectomy cases: the Indianapolis experience. J Urol 2002; 168: 1361-1365. 12) Modine T, Lions C, Destrieux-Garnier L, et al: Iatrogenic iliac artery rupture and type a dissection after endovascular repair of type B aortic dissection. Ann Thorac Surg 2004; 77: 317-319. 19) Pourmoghadam KK, Fogler RJ, Shaftan GW: Ligation: an alternative for control of exsanguination in major vascular injuries. J Trauma 1997; 43: 126-130. 13) Sakamoto I, Hayashi K, Matsunaga N, et al: Aortic dissection caused by angiographic procedures. Radiology 1994; 191: 467-471. 2) Mucha P Jr, Welch TJ: Hemorrhage in major pelvic fractures. Surg Clin North Am 1988; 68: 757-773. 16) Ivatury RR, Kazigo J, Rohman M, et al: “Directed” emergency room thoracotomy: a prognostic prerequisite for survival. J Trauma 1991; 31: 1076-1082. 21) Cue JI, Cryer HG, Miller FB, et al: Packing and planned reexploration for hepatic and retroperitoneal hemorrhage: critical refinements of a useful technique. J Trauma 1990; 30: 1007-1013. 6) Nordestgaard AG, Bodily KC, Osborne RW Jr, et al: Major vascular injuries during laparoscopic procedures. Am J Surg 1995; 169: 543-545. 9) Smythe WR, Carpenter JP: Upper abdominal aortic injury during spinal surgery. J Vasc Surg 1997; 25: 774-777. 4) Saunders MS, Riberi A, Massullo EA: Delayed traumatic superior mesenteric arteriovenous fistula after a stab wound: case report. J Trauma 1992; 32: 101-106. 17) Feliciano DV, Bitondo CG, Cruse PA, et al: Liberal use of emergency center thoracotomy. Am J Surg 1986; 152: 654-659. 14) Adkins RB Jr, Bitseff EL Jr, Meacham PW: Abdominal vascular injuries. South Med J 1985; 78: 1152-1160. 18) Rotondo MF, Schwab CW, McGonigal MD, et al: ‘Damage control’: an approach for improved survival in exsanguinating penetrating abdominal injury. J Trauma 1993; 35: 375-383. 22) Klein SR, Mehringer CM, Bongard FS: Endovascular occlusive intervention in the management of trauma. Ann Vasc Surg 1990; 4: 424-430. |
| References_xml | – reference: 8) Chaikof EL, Shamberger RC, Brewster DC: Traumatic pseudoaneurysms of the abdominal aorta. J Trauma 1985; 25: 169-173. – reference: 23) 宮田哲郎: 腹部血管解剖. 宮田哲郎編, 一般外科医のための血管外科の要点と盲点. 第1版, 東京, 文光堂, 2001: 12-17. – reference: 15) Collins PS, Golocovsky M, Salander JM, et al: Intra-abdominal vascular injury secondary to penetrating trauma. J Trauma 1988; 28: S 165-170. – reference: 5) Chase CW, Layman TS, Barker DE, et al: Traumatic abdominal aortic pseudoaneurysm causing biliary obstruction: a case report and review of the literature. J Vasc Surg 1997; 25: 936-940. – reference: 2) Mucha P Jr, Welch TJ: Hemorrhage in major pelvic fractures. Surg Clin North Am 1988; 68: 757-773. – reference: 9) Smythe WR, Carpenter JP: Upper abdominal aortic injury during spinal surgery. J Vasc Surg 1997; 25: 774-777. – reference: 7) Siqueira TM Jr, Kuo RL, Gardner TA, et al: Major complications in 213 laparoscopic nephrectomy cases: the Indianapolis experience. J Urol 2002; 168: 1361-1365. – reference: 18) Rotondo MF, Schwab CW, McGonigal MD, et al: ‘Damage control’: an approach for improved survival in exsanguinating penetrating abdominal injury. J Trauma 1993; 35: 375-383. – reference: 11) May J, Schulze K: Successful completion of endoluminal repair of an abdominal aortic aneurysm after intraoperative iatrogenic rupture of the aneurysm. J Vasc Surg 1999; 30: 901-906. – reference: 4) Saunders MS, Riberi A, Massullo EA: Delayed traumatic superior mesenteric arteriovenous fistula after a stab wound: case report. J Trauma 1992; 32: 101-106. – reference: 1) Carrillo EH, Bergamini TM, Miller FB, et al: Abdominal vascular injuries. J Trauma 1997; 43: 164-171. – reference: 20) Richardson JD, Polk HC Jr: Reoperation for trauma. Ann Surg 1995; 222: 1-2. – reference: 3) Lassonde J, Laurendeau F: Blunt injury of the abdominal aorta. Ann Surg 1981; 194: 745-748. – reference: 21) Cue JI, Cryer HG, Miller FB, et al: Packing and planned reexploration for hepatic and retroperitoneal hemorrhage: critical refinements of a useful technique. J Trauma 1990; 30: 1007-1013. – reference: 14) Adkins RB Jr, Bitseff EL Jr, Meacham PW: Abdominal vascular injuries. South Med J 1985; 78: 1152-1160. – reference: 19) Pourmoghadam KK, Fogler RJ, Shaftan GW: Ligation: an alternative for control of exsanguination in major vascular injuries. J Trauma 1997; 43: 126-130. – reference: 10) Montero M, Tellado MG, Rios J, et al: Aortic injury during diagnostic pediatric laparoscopy. Surg Endosc 2001; 15: 519. – reference: 16) Ivatury RR, Kazigo J, Rohman M, et al: “Directed” emergency room thoracotomy: a prognostic prerequisite for survival. J Trauma 1991; 31: 1076-1082. – reference: 12) Modine T, Lions C, Destrieux-Garnier L, et al: Iatrogenic iliac artery rupture and type a dissection after endovascular repair of type B aortic dissection. Ann Thorac Surg 2004; 77: 317-319. – reference: 13) Sakamoto I, Hayashi K, Matsunaga N, et al: Aortic dissection caused by angiographic procedures. Radiology 1994; 191: 467-471. – reference: 6) Nordestgaard AG, Bodily KC, Osborne RW Jr, et al: Major vascular injuries during laparoscopic procedures. Am J Surg 1995; 169: 543-545. – reference: 22) Klein SR, Mehringer CM, Bongard FS: Endovascular occlusive intervention in the management of trauma. Ann Vasc Surg 1990; 4: 424-430. – reference: 17) Feliciano DV, Bitondo CG, Cruse PA, et al: Liberal use of emergency center thoracotomy. Am J Surg 1986; 152: 654-659. |
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| SubjectTerms | damage control surgery 穿通外傷 腸骨動脈損傷 腹部大動脈損傷 |
| Title | Abdominal Vascular Injuries |
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