膈肌动脉出血.pptENGLISH.ppt

Schematic diagram of the internalmammary artery A rare case of diaphragm artery rupture Dengke Zhang Radiology Department Lishui Central Hospital Clinical Information Male，32y Unconsciousness after high falling injury 19h Deep coma,Nasal bleeding,Unstable vital signs Routine blood tests:WBC1.36×10^12/L，HGB41g/L Blood gas analysis:?PH7.149，PCO 241.3mmHg Chest CT--preoperative l Abdominal CT --preoperative Head CT --preoperative  DSA image （2013.4.12 12：39） DSA image （2013.4.12 12：39） Chest radiograph （2013.4.12 19：50） Operation Diaphragm artery is spurting active hemorrhage Discuss Anatomy of diaphragm artery Mechanism Diagnosis Treatment Diaphragm Artery Anatomy Composition :Phrenic artery, pericardiac phrenic artery and muscle phrenic artery, phrenic artery, the branch of the after lower intercostals arteries Starting position :Dry celiac arteries, abdominal aorta, renal artery, left gastric artery; Within the thoracic artery; the aortic hiatus 李志坚,王茂强,中国人膈下动脉血管造影解剖研究,中国医学影像学杂志 2003年第 11卷第 2期,89-91 1Pericardiacophrenic artery, 2superior epigastric artery, 3musculophrenic artery, 4diaphragmatic branch of musculophrenic artery 5anterior intercostal artery, 6phrenic branch, 7ensiform artery. Kim et al, Hepatocellular Carcinoma Supplied by Mammary ArteryRadiology,2007:925-932 Mechanism Chest and abdomen pressure suddenly rise Stress point Fractured ribs or other penetrating injury Giorgio Bocchini , Franco Guida Giacomo Sica ,Umberto Codella,Mariano Scaglione, Diaphragmatic injuries after blunt trauma:are they still a challenge? Emerg Radiol (2012) 19:225–235 Diagnosis Rupture location:Most on the left side Reason: Giorgio Bocchini , Franco Guida Giacomo Sica ,Umberto Codella,Mariano Scaglione, Diaphragmatic injuries after blunt trauma:are they still a challenge? Emerg Radiol (2012) 19:225–235 left diaphragmatic muscle weakness liver bu