Affiliation:
1. Department of Thoracic Surgery N.V. Sklifosovsky Research Institute for Emergency Medicine
Abstract
The possibilities of computed tomography in the diagnosis of spontaneous hematomas (sh) of the soft tissues of the neck and chest and the features of their treatment are shown. Computed tomography with intravenous bolus contrast enhancement is the main method for diagnosing sh, which allows you to specify its exact localization, distribution, determine the structure and volume of the hematoma, the contrast agent exiting the contours of the vessel, and, taking into account the data obtained and the clinic, determines the tactics of treatment.Stable sh does not require surgical treatment. In the case of a large volume of chest hematoma, compression syndrome, hemothorax, drainage is indicated. Unstable sh dictate the need for angiography and, if necessary, endovascular embolization.
Publisher
The Scientific and Practical Society of Emergency Medicine Physicians
Reference39 articles.
1. Nakayama M, Kato K, Yoshioka K, Sato H. Coagulopathy-related soft tissue hematoma: a comparison between computed tomography findings and clinical severity. Acta Radiologica Open. 2020;9(5):2058460120923266. PMID: 32528727 https://doi.org/10.1177/2058460120923266
2. Smithson A, Ruiz J, Perello R, Valverde M, Ramos J, Garzo L. Diagnostic and management of spontaneous rectus sheath hematoma. Eur J Intern Med. 2013;24(6):579–582. PMID: 23535226 https://doi.org/10.1016/j.ejim.2013.02.016
3. Furlan A, Fakhran S, Federle MP. Spontaneous abdominal hemorrhage: causes, CT findings, and clinical implications. AJR Am J Roentgenol. 2009;193(4):1077–1087. PMID: 19770332 https://doi.org/10.2214/AJR.08.2231
4. Federle MP, Pan KT, Pealer KM. CT criteria for differentiating abdominal hemorrhage: anticoagulation or aortic aneurysm rupture? AJR Am J Roentgenol. 2007;188(5):1324–1330. PMID: 17449778 https://doi.org/10.2214/AJR.05.1911
5. Pavlov VN, Safiullin RI, Sakhautdinov DR, Mustafin AT, Korzhavin VG, Kazikhinurov AA. Remote Results of Surgical Treatment of Hemorrhagic Fever With Renal Syndrome Complications. Bashkortostan Medical Journal. 2012;7(6):56–59. (in Russ.).