POCUS and POCDUS : essential tools for the evaluation and management of carotid artery pseudoaneurysms after a gunshot wound
BACKGROUND: Evaluation of asymptomatic penetrating vascular injuries can be done with Point-of-care ultrasound (POCUS) and Point-of-care Doppler ultrasound (POCDUS).
CASE PRESENTATION: A 21-year-old woman was admitted to the Emergency Department with a small wound and pain on the left side of her neck. The patient stated she was standing outside her home and suddenly felt acute pain in the neck. She denied trauma or being assaulted and reported no significant past medical or surgical history. On physical exam the only positive finding was a small gunshot entry wound on the left side of her neck without hard signs of vascular injury. Bedside POCUS demonstrated soft tissue swelling and a hematoma next to the left carotid artery. A round in shape bullet was visualized in contact with the posterior left common carotid artery wall and two small saccular pseudoaneurysms were seen at left common carotid artery wall. POCDUS showed a patent left carotid artery and turbulent flow in the two saccular aneurysms. A computed tomography angiogram (CTA) was performed confirming the findings and a stent in left carotid artery was placed. The patient tolerated the procedure well and was discharged 4 days after the procedure. At the sixth month follow-up, Doppler ultrasound showed patent stent and resolution of the muscular hematoma.
CONCLUSIONS: Penetrating trauma-related vascular injuries are complex cases to handle within an acute setting. POCUS and POCDUS are increasingly being used for the workup and decision-making process of gunshot-related vascular injuries to the neck and are a fundamental part of the follow-up after definitive therapy.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
|---|---|
| Enthalten in: |
The ultrasound journal - 12(2020), 1 vom: 22. Juli, Seite 35 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Montorfano, Lisandro [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Carotid injury |
|---|
| Anmerkungen: |
Date Revised 29.03.2024 published: Electronic Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1186/s13089-020-00182-7 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM312723288 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM312723288 | ||
| 003 | DE-627 | ||
| 005 | 20240329233640.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1186/s13089-020-00182-7 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1354.xml |
| 035 | |a (DE-627)NLM312723288 | ||
| 035 | |a (NLM)32696140 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Montorfano, Lisandro |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a POCUS and POCDUS |b essential tools for the evaluation and management of carotid artery pseudoaneurysms after a gunshot wound |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 29.03.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a BACKGROUND: Evaluation of asymptomatic penetrating vascular injuries can be done with Point-of-care ultrasound (POCUS) and Point-of-care Doppler ultrasound (POCDUS) | ||
| 520 | |a CASE PRESENTATION: A 21-year-old woman was admitted to the Emergency Department with a small wound and pain on the left side of her neck. The patient stated she was standing outside her home and suddenly felt acute pain in the neck. She denied trauma or being assaulted and reported no significant past medical or surgical history. On physical exam the only positive finding was a small gunshot entry wound on the left side of her neck without hard signs of vascular injury. Bedside POCUS demonstrated soft tissue swelling and a hematoma next to the left carotid artery. A round in shape bullet was visualized in contact with the posterior left common carotid artery wall and two small saccular pseudoaneurysms were seen at left common carotid artery wall. POCDUS showed a patent left carotid artery and turbulent flow in the two saccular aneurysms. A computed tomography angiogram (CTA) was performed confirming the findings and a stent in left carotid artery was placed. The patient tolerated the procedure well and was discharged 4 days after the procedure. At the sixth month follow-up, Doppler ultrasound showed patent stent and resolution of the muscular hematoma | ||
| 520 | |a CONCLUSIONS: Penetrating trauma-related vascular injuries are complex cases to handle within an acute setting. POCUS and POCDUS are increasingly being used for the workup and decision-making process of gunshot-related vascular injuries to the neck and are a fundamental part of the follow-up after definitive therapy | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Carotid injury | |
| 650 | 4 | |a Doppler ultrasound | |
| 650 | 4 | |a POCDUS | |
| 650 | 4 | |a POCUS | |
| 650 | 4 | |a Penetrating trauma | |
| 650 | 4 | |a Point-of-care Doppler ultrasound | |
| 650 | 4 | |a Point-of-care ultrasound | |
| 650 | 4 | |a Pseudoaneurysm | |
| 650 | 4 | |a Vascular injury | |
| 700 | 1 | |a Sarkissyan, Marianna |e verfasserin |4 aut | |
| 700 | 1 | |a Wolfers, Matthew |e verfasserin |4 aut | |
| 700 | 1 | |a Rodríguez, Federico |e verfasserin |4 aut | |
| 700 | 1 | |a Pla, Fernando |e verfasserin |4 aut | |
| 700 | 1 | |a Montorfano, Miguel |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The ultrasound journal |d 2019 |g 12(2020), 1 vom: 22. Juli, Seite 35 |w (DE-627)NLM299707652 |x 2524-8987 |7 nnns |
| 773 | 1 | 8 | |g volume:12 |g year:2020 |g number:1 |g day:22 |g month:07 |g pages:35 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1186/s13089-020-00182-7 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 12 |j 2020 |e 1 |b 22 |c 07 |h 35 | ||