ABSTRACT
CASE: Vertebral artery injury is a low-frequency but high-mortality injury. The surgical approach to a bleeding vertebral artery injury is one of the most difficult procedures in trauma surgery.A 64-year-old woman was transported to our emergency department after being stabbed in the middle side of the right neck with a large kitchen knife. Her initial hospital examination indicated a shock state, and computed tomography images revealed a right vertebral artery injury. We undertook angiography and transcatheter arterial embolization before the surgical operation. OUTCOME: The patient suffered right upper extremity paralysis due to brachial plexus injury and was transferred to another hospital for rehabilitation on the 24th hospital day. CONCLUSION: Computed tomography angiography for diagnosis and interventional radiology treatment are useful for the management of penetrating neck trauma. Transcatheter arterial embolization for vertebral artery injury is safe and allows for easy control of bleeding compared to a surgical procedure.
ABSTRACT
A 56-year-old man was admitted to our hospital with a history of abdominal discomfort and loss of appetite. Six days later, he suddenly went into shock; despite repeated blood transfusions, he died. Autopsy revealed the cause of death to be a ruptured splenic angiosarcoma, which had metastasized to multiple sites in the liver and bone. Splenic angiosarcoma is rare, and its pathophysiology is unclear. When presented with splenic angiosarcoma or suggestive symptoms, including splenic bleeding, splenomegaly, abdominal discomfort, and abdominal pain, we should carefully monitor the patient for signs of coagulopathy and prepare for the possibility of rapid progression to disseminated intravascular coagulation. In general, patients with angiosarcoma have a poor prognosis. Therefore, we hope this report will help in improving the prognosis of patients suffering from angiosarcoma by contributing to the limited clinical experience.
