Clinical Challenges in Trauma Surgery: Penetrating Great Vessel Injury

Behind The Knife: The Surgery Podcast

We are facing a difficult case tonight: stab wound to the base of the left neck. Hope you know your anatomy well and are ready for a ride. Let’s see how one manages a patient whose injury is life threatening, a challenge to correctly diagnose, approach and repair.
Join Drs. Urréchaga, Neeman, and Rattan from Ryder Trauma Center in Miami as they go through a real case trying to save a life and dominate the day.
Learning Objectives:

• Reviewing thoracic outlet anatomy.
• Simplifying primary survey and immediate care for penetrating great vessel injuries.
• Discussing possible surgical approaches for various great vessel injuries, incisions, extensions, tips and tricks.

References
1) Feliciano DV, DuBose JJ. Cardiac, great vessel, and pulmonary injuries. In: Rasmussen TR, Tai NRM, eds. Rich’s Vascular Trauma. 4th ed. Philadelphia: Elsevier, 2022: 171-198.
2) Karmy-Jones R, Namias N, Coimbra R, et al. Western Trauma Association critical decisions in trauma: penetrating chest trauma. J Trauma Acute Care Surg. 2014;77(6):994-1002.
3) Sperry JL, Moore EE, Coimbra R, et al. Western Trauma Association critical decisions in trauma: penetrating neck trauma. J Trauma Acute Care Surg. 2013;75(6):936-940.
4) Wall MJ, Ghanta RK, Mattox KL. Heart and thoracic vessels. In: Feliciano DV, Mattox K L, Moore EE, eds. Trauma. 9th ed. New York: McGraw-Hill, 2021: 599- 628.
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