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Case Report
Right subclavian artery injury secondary to blunt trauma successfully treated in a patient with situs inversus totalis: Case report
1 Vascular Surgeon - Hospital Público Regional de Betim Osvaldo Rezende Franco (HRPB), Betim - MG, Brazil
2 Medical student - Faculdade de Medicina de Barbacena (FAME/FUNJOB), Barbacena - MG, Brazil
3 Vascular Surgery Residency Program Diretor - Hospital Público Regional de Betim Osvaldo Rezende Franco (HRPB), Betim - MG, Brazil
4 Chief of Vascular Surgery - Hospital Público Regional de Betim Osvaldo Rezende Franco (HRPB), Betim - MG, Brazil
Address correspondence to:
Daniel Corradi Carregal
Hospital Público Regional de Betim Osvaldo Rezende Franco (HRPB), Av. Edmeia Matos Lazzarotti, 3800 - Jardim Brasilia, Betim - MG, 32671-602,
Brazil
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Article ID: 101275Z01DC2021
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How to cite this article
Carregal DC, Rabelo PMA, Amaral MTP, Souza Junior FDPA, Fiqueiredo Junior FDAF. Right subclavian artery injury secondary to blunt trauma successfully treated in a patient with situs inversus totalis: Case report. Int J Case Rep Images 2021;12:101275Z01DC2021.ABSTRACT
Introduction: Subclavian artery injury secondary to blunt trauma is rare. Most patients with blunt trauma that affects the major vessels die before reaching the hospital due to trauma kinematics. Appropriate intervention requires immediate identification and proper surgical approach. The intraoperative diagnosis is more common due to the hemodynamic instability of most patients; however, conventional angiography and computed tomography (CT) angiography are also useful diagnostic modalities in stable patients to determine the location of the injury prior to surgery. We present a case of blunt trauma associated with situs inversus totalis which is a rare congenital condition characterized by complete transposition of the thoracic and abdominal viscera.
Case Report: A 22-year-old man was brought to our trauma center, victim of motorcycle collision, with an occlusive bandage on the right neck/thoracic region. Due to hemodynamic stability, CT scan conducted directly. The patient was treated with surgical exploration of the injury with a supraclavicular incision, osteotomy of the middle third of the clavicle, proximal, and distal control of the subclavian artery. There was no evidence of brachial plexus injury. Small laceration was identified in the right subclavian artery caused by a bone fragment of the clavicle fracture. We performed a debridement of the subclavian injury and primary suture with Prolene 5-0.
Conclusion: Treatment of the subclavian artery trauma requires solid anatomy for understanding the accurate localization of the arterial injury—when possible—prior to surgery to ensure the approach will be target effective with minimal time loss.
Keywords: Blunt trauma, Subclavian artery injury, Trauma outcomes, Vascular repair, Vascular surgery
SUPPORTING INFORMATION
Author Contributions
Daniel Corradi Carregal - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Paloma Maciel Araujo Rabelo - Conception of the work, Design of the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Maria Teresa Prata Amaral - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Francisco De Paula Alves Souza Junior - Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Fernando De Assis Fiqueiredo Junior - Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Daniel Corradi Carregal et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
