The Turkish Journal of Vascular Surgery

Yazarlar: Ömer Çakır, Nesimi Eren, Kemalettin Erdem

Konular:-

Anahtar Kelimeler:Arterial injury,Delayed diagno sis,Arteriovenous fistu,A pseudoaneurysm,Arterial occlusion

Özet: From 1987 to 2001, 72 patients with a delayed diagnosis of an arterial injury in the extremity and neck were treated at our department. The median delay between injury and diagnosis was 4.3±14.6 (12 hours-7 years) months. Forty­ eight patieı:ıts were seen by physicians of di fferent disciplines and different levels of training. According to analysis of histories and the records of patients, 41 patients didn't have hard signs of vascular injury at the time of initial evalu­ ation after trauma. Surgical exploration was performed in 7 patients. Diagnosis was delayed because of social re­ asons in 24 patients. Complications of missed arterial injuries included the following: pseudoaneurysm, 23 (42%); ar­ teriovenous fistula, 18 (26%); occlusion, hemorrhage and hematoma, 30 (42%). The superficial femoral artery (n=19) was the most commonly injured vessel. The remaining arteries included the following: carotid, 4; subclavian, 2; axil­ lary, 4; brachial, 8; radial or ulnar, 6; glutealis superior, 1; common femoral, 4; profunda femoris, 3; popliteal, 15; tibi­ operoneal, 5. Sixty-six patients had penetrating wounrls (24 stab wounds, 22 gunshut, 14 shutgun, 6 fragments), only 6 patients had blunt trauma. AII patients underwent urgery. Three (4%) pat ients underwent amputation. Mortality was 4% (3 cases). Traumatic arterial injuries can resul! in serious delayed complications months or even years after the injury. Prompt diagnosis and definitive treatment are essential in preventing the late sequelae of untreated vascular injuries including arterial occlusion, hemorrhage, pseudoaneurysm and arteriovenous fistula.

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