Neck trauma - USarpel

Neck trauma - USarpel - Penetrating Neck Trauma Umut Sarpel...

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Unformatted text preview: Penetrating Neck Trauma Umut Sarpel PGY-4 Case Presentation • 31M • No PMHx • Single GSW to neck • Handgun at 15 ft range Case Presentation • Hemodynamically stable • 130/75, 86, 18, 99% on NC • Spontaneous, regular respirations Exam • 0.5 cm entry wound at midline in Zone I • No exit wound • Small hematoma, no active bleeding • No crepitus • Breath sounds b/l • 2+ pulses b/l UE • 4/4 strength, sensation b/l • CN II-XII grossly intact Management • Labs - Hct 44 otherwise unremarkable • CXR obtained Management • CXR: R hemothorax • R chest tube 500 cc blood • Flexible laryngoscopy no obvious injury • Airway control fiberoptic awake nasotracheal intubation by anesthesia Management • Angiogram obtained: Operative Course • Median sternotomy • Pseudoaneurysm of brachiocephalic artery • Proximal/distal control • Interposition graft with PTFE from brachiocephalic to subclavian artery Operative Course • Injury to brachiocephalic vein noted; controlled and ligated • Neck dissection no tracheal injury • Rigid esophagoscopy no injury noted Post-Op Course...
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Neck trauma - USarpel - Penetrating Neck Trauma Umut Sarpel...

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