Proximity Penetrating Extremity Trauma
| Autor: | Paul J. Gagne, Lon G. Bitzer, Rhonda Troillett, John B. Cone, John F. Eidt, David R. McFarland, Michael J. Vitti |
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| Rok vydání: | 1995 |
| Předmět: |
Adult
Male medicine.medical_specialty Duplex ultrasonography Adolescent Deep vein Venography Physical examination Veins medicine Humans Prospective Studies Leg Ultrasonography Doppler Duplex medicine.diagnostic_test business.industry Arteries Phlebography medicine.disease Thrombosis Occult Surgery Pulmonary embolism medicine.anatomical_structure Angiography Female Wounds Gunshot Radiology business Leg Injuries |
| Zdroj: | The Journal of Trauma: Injury, Infection, and Critical Care. 39:1157-1163 |
| ISSN: | 1079-6061 |
| Popis: | The diagnosis and management of occult vascular injuries caused by penetrating proximity extremity trauma (PPET) remains controversial. Over 18 months, we prospectively screened 37 patients (43 lower extremities) with PPET for occult arterial and venous injuries using noninvasive studies (physical examination, ankle-brachial indices, color-flow duplex ultrasonography (CFD)) and angiography (arteriography, venography). Eight isolated, occult venous injuries were detected (incidence, 22%). CFD detected seven of eight (88%) venous injuries. Venography was technically difficult to perform in this patient population and failed to detect four femoral-popliteal vein injuries. Major thromboembolic complications (pulmonary embolism, symptomatic deep vein thrombosis, venous claudication) occurred in 50% of the patients identified with femoral-popliteal vein injuries. Arterial injuries were detected in 4 of 42 (10%) extremities (arteriography, n = 3; CFD, n = 1) and were clinically benign. We conclude that following PPET, (1) isolated, occult venous injuries are common and are associated with significant complications and (2) CFD is useful for screening for occult venous injuries. |
| Databáze: | OpenAIRE |
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