흉부 손상과 함께 우상지에 절단에 가까운 열창을 입은 교통 사고 환자에서 발견된 폐동맥 내 이물질 - 1예 보고 -

A Foreign Body Found in the Pulmonary Artery of a Traffic Accident Victim with a Chest Injury and Near-amputation of the Upper Extremity - A case report -

  • 최광민 (한림대학교 의과대학 한림대학교의료원 흉부외과학교실) ;
  • 김흥철 (한림대학교 의과대학 한림대학교의료원 영상의학교실) ;
  • 조광윤 (한림대학교 의과대학 한림대학교의료원 응급의학교실) ;
  • 김형수 (한림대학교 의과대학 한림대학교의료원 흉부외과학교실)
  • Choi, Goang-Min (Department of Thoracic and cardiovascular Surgery, Hallym University Medical Center, College of Medicine, Hallym University) ;
  • Kim, Heung-Cheol (Department of Radiology, Hallym University Medical Center, College of Medicine, Hallym University) ;
  • Cho, Kwang-Yun (Department of Emergency Medicine, Hallym University Medical Center, College of Medicine, Hallym University) ;
  • Kim, Hyung-Soo (Department of Thoracic and cardiovascular Surgery, Hallym University Medical Center, College of Medicine, Hallym University)
  • 발행 : 2008.08.05

초록

52세 여자는 승용차 조수석에 앉아가다가 타차와 충돌후 다발성 늑골골절과 혈기흉과 함께 다량의 출혈을 야기한 우측 전완의 절단에 가까운 손상을 입었다. 응급실에 도착시 명료하지 못한 의식과 저혈압의 소견을 보였다. 혈액량 감소 쇼크로 판단되어 다량의 혈액과 수액을 급속수액주입기(레벨 1)를 이용하여 좌측 쇄골하정맥관을 통해 주입하였다. 폐좌상의 소견이 호전되었을 때 일반 흉부 X선 사진의 좌폐야에 이물질이 확인되었다. 폐동맥조영술에서 15 cm 정도의 이물질이 좌측 폐기저동맥에 있었다. 경피적 중재시술을 통해 혈관 겸자로 잡아 제거할 수 있었다.

We present a case with a foreign body in the left pulmonary artery, found in a traffic accident victim. A 52-year-old woman sitting in the passenger side of a car had massive bleeding and near complete amputation of her right forearm in addition to multiple rib fractures and a hemopneumothorax. At arrival to the emergency room, the patient had signs of shock; she was anemic, drowsy and hypotensive. A large volume of blood and crystalloid fluids were administered via the left subclavian vein with a rapid infusion device (Level $1^{(R)}$). As the lung contusion improved, a foreign body was noticed in the left lung field on plain x-rays. Pulmonary angiography was performed and revealed a 15 cm foreign body in the left basal segment of the common pulmonary artery. The foreign body was successfully retrieved using vascular forceps via the percutaneous femoral vein approach.

키워드

참고문헌

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