Résumé
No abstract available.
Sujets)
Adulte , Femelle , Humains , Maladie aigüe , Fistule artérioveineuse/diagnostic , Tronc brachiocéphalique/traumatismes , Veines brachiocéphaliques/traumatismes , Luxations/chirurgie , Échocardiographie-doppler couleur , Défaillance cardiaque/diagnostic , Maladie iatrogène , Procédures orthopédiques/effets indésirables , Réintervention , Articulation sternoclaviculaire/chirurgie , Tomodensitométrie , Résultat thérapeutique , Lésions du système vasculaire/diagnosticRésumé
Descrevemos caso de paciente do sexo masculino, 49 anos, que sofreu ferimento por arma de fogo no tórax, transfixando o mediastino médio. Apresentava-se estável hemodinamicamente, contudo taquicárdico e taquipnéico. Ele foi submetido à propedêutica armada com radiograma de tórax, ecocardiografia transtorácica, tomografia computadorizada de tórax e arteriografia do arco aórtico. Evidenciou-se fístula traumática do tronco braquiocefálico com a veia braquiocefálica. Realizou-se correção cirúrgica com a utilização de circulação extracorpórea e hipotermia profunda com parada circulatória total. O paciente evolui bem com alta no quinto pós-operatório.
We describe the case of a 49-year old male patient who suffered a gunshot wound in the chest which transfixed the medial mediastinum. He was hemodynamically stable, but had tachycardia and tachypnea. He was submitted to integrated work-up with chest radiogram, transthoracic echocardiography, computerized chest tomography, and arteriography of the aortic arch. A traumatic fistula was evidenced between the brachiocephalic trunk and the brachiocephalic vein. Surgical repair was performed using extracorporeal circulation and deep hypothermia with total circulatory arrest. The patient progressed well and was discharged on the fifth day postoperatively.