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标题：Successful management of severe penetrating abdominal aortic injury by the Pringle maneuver and thoracic aortic cross-clamping
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作者：Jun-ichi Hirata ; Munehiko Ohya ; Keiji Kumon 等
期刊名称：循環制御
印刷版ISSN：0389-1844
出版年度：2014
卷号：35
期号：3
页码：227-231
DOI：10.11312/ccm.35.227
出版社：Japan Society of Circulation Control in Medicine
摘要：Background: Hemorrhage shock following penetrating abdominal aortic injury leads to high mortality during the perioperative period. Case: A 32-year old woman was admitted for severe hemorrhagic shock due to a self-inflicted knife wound that penetrated her right upper abdominal quadrant and was visible on ultrasound examination as a massive zone 1 hematoma. Her vitals upon admission were as follows: an unreadable systolic blood pressure(extremely low), a pulse rate of 139 beats per minute, respiratory rate of 40 breaths per minute, and peripheral oxygen saturation of 81% of room air. An emergency transperitoneal operation was performed. Massive bleeding occurred from a retroperitoneal hematoma, followed by bradycardia. Pringle maneuver and thoracic aortic cross-clamping procedures were performed simultaneously, followed by diaphragmatic aortic compression. Total estimated blood loss amounted to 10,000 mL, which warranted an infusion of 30,000 mL of fluids. The patient was diagnosed with duodenal, liver, superior mesenteric vein, and abdominal aortic penetrating injuries, which were repaired under direct vision. The patient's postoperative recovery was successful and uneventful. Conclusion: The Pringle maneuver and thoracic aortic cross-clamping procedures followed by diaphragmatic aortic compression were effective on active hemorrhage and ruptured the hematoma.
关键词：penetrating abdominal aortic trauma ; hemorrhagic shock ; thoracic aortic cross-clamping ; diaphragmatic aortic compression ; Pringle maneuver