An unusual case of a patient who presented with haemorrhagic shock following massive subcutaneous haematomas of the lower back due to blunt trauma.

Abstract

An 83-year-old woman with no significant medical history was transferred to our tertiary hospital after being hit by a car and presenting with haemorrhagic shock. Immediate fluid resuscitation was performed; physical, chest/pelvic X-ray and echographic examinations did not detect any major sources of bleeding. However, a contrast-enhanced CT scan revealed multiple regions of significant contrast extravasation in an extensive part of the subcutaneous tissue of the patient's lower back, which is an unusual source of bleeding. Transcatheter arterial embolisation of the lumbar and internal iliac arteries and their branches was carried out. In addition, haemostatic resuscitation was performed for damage control resuscitation, which successfully resolved the patient's haemorrhagic shock.

• Authors: Tetsuya Yumoto, Keiji Sato, Toyomu Ugawa, Yoshihito Ujike
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2015 (Oct 14 2015) ISSN: 1757-790X [Electronic] England
• PMID: 26468221 (Publication Type: Case Reports, Journal Article)
• Copyright: 2015 BMJ Publishing Group Ltd.

Topics

• Accidents, Traffic
• Aged, 80 and over
• Back Injuries (complications)
• Embolization, Therapeutic
• Female
• Hematoma (etiology, therapy)
• Humans
• Iliac Artery
• Lumbar Vertebrae (blood supply)
• Resuscitation
• Shock, Hemorrhagic (etiology, therapy)
• Subcutaneous Tissue (injuries)
• Wounds, Nonpenetrating (complications)