Can a breast hematoma lead to hemorrhagic shock in elderly trauma patients with multiple comorbidities and reduced physiological reserve? Examining the risks and management strategies

Q4 Medicine

Radiology Case Reports Pub Date : 2024-10-26 DOI:10.1016/j.radcr.2024.10.011

Oluwasemilore Okunlola MD , Mena Louis DO , Nathaniel Grabill MD , Priscilla Strom MD , Brian Gibson MD

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引用次数: 0

Abstract

Breast trauma in elderly patients with multiple comorbidities can result in severe complications such as hemorrhagic shock due to the highly vascular nature of breast tissue. This case involves a 65-year-old female with a history of rheumatoid arthritis and prior breast cancer who developed a significant breast hematoma following a motor vehicle accident. Initially stable, she rapidly deteriorated with hypotension and altered mental status after imaging revealed a large hematoma with active hemorrhage. Immediate intervention, including blood transfusion and intubation, was essential for stabilization. While spontaneous cessation of bleeding and hematoma stabilization can negate the need for further intervention, persistent bleeding requires prompt action. Options include surgical exploration, hematoma evacuation, vessel ligation, interventional radiology for embolization, additional blood transfusions, and pharmacological hemostatic agents. Breast hematoma can lead to hemorrhagic shock if severe enough in elderly patients with reduced physiological reserve.

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对于患有多种并发症和生理储备功能降低的老年创伤患者，乳房血肿会导致失血性休克吗？研究风险和管理策略

由于乳房组织的高血管性，患有多种并发症的老年患者的乳房外伤可能会导致严重的并发症，如失血性休克。本病例涉及一名 65 岁女性，她有类风湿性关节炎和乳腺癌病史，在一次车祸后出现了严重的乳房血肿。她的病情最初比较稳定，但在影像学检查发现大血肿并伴有活动性出血后，病情迅速恶化，出现低血压和精神状态改变。为了稳定病情，必须立即进行干预，包括输血和插管。虽然出血自发停止和血肿稳定可以排除进一步干预的必要性，但持续出血需要及时采取措施。可供选择的方法包括手术探查、血肿清除、血管结扎、介入放射学栓塞、额外输血和药物止血剂。对于生理机能减退的老年患者，如果乳房血肿严重，可导致失血性休克。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiology Case Reports Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

1.10

自引率

0.00%

发文量

1074

审稿时长

30 days

期刊介绍： The content of this journal is exclusively case reports that feature diagnostic imaging. Categories in which case reports can be placed include the musculoskeletal system, spine, central nervous system, head and neck, cardiovascular, chest, gastrointestinal, genitourinary, multisystem, pediatric, emergency, women''s imaging, oncologic, normal variants, medical devices, foreign bodies, interventional radiology, nuclear medicine, molecular imaging, ultrasonography, imaging artifacts, forensic, anthropological, and medical-legal. Articles must be well-documented and include a review of the appropriate literature.