Fractured cervical spine and aortic transection.
A 17-year-old victim of a road traffic accident presented. Following investigation diagnoses of fractured first cervical vertebra, aortic transection, diffuse cerebral oedema, fractured right ribs 2-4 and pubic rami were made. Management of this case presented a number of anaesthetic dilemmas: management of the airway, use of cross-clamp vs. shunting or heparinization and bypass, cardiovascular and neurological monitoring, maintenance of cardiovascular stability during and post cross-clamp, minimizing the risk of post-operative renal and neurological dysfunction.
Department of Anaesthesia and Intensive Care, Cork University Hospital, Wilton, Ireland.
M J
MJ
Griffin
M
M
Harnett
P
P
Kenefick
D000063:Accidents, Traffic; D000293:Adolescent; D000768:Anesthesia, General; D000925:Anticoagulants; D001019:Aortic Rupture / Q000601:surgery*; D001929:Brain Edema / Q000150:complications; D002315:Cardiopulmonary Bypass; D001270:Cervical Atlas / Q000293:injuries* / Q000601:surgery; D000075202:Contraindications; D005260:Female; D050723:Fractures, Bone / Q000150:complications; D006429:Hemiplegia / Q000209:etiology / Q000628:therapy; D006493:Heparin; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods; D016343:Monitoring, Intraoperative; D011183:Postoperative Complications; D011630:Pubic Bone / Q000293:injuries; D012253:Rib Fractures / Q000150:complications; D012307:Risk Factors; D016103:Spinal Fractures / Q000601:surgery*
D000925:Anticoagulants; D006493:Heparin