[Acute carotid thrombosis in penetrating traumatism: is revascularization necessary in the patient without central neurological deficit?].
BACKGROUND
Carotid lesions require priority in both evaluation and treatment due to their high morbidity and mortality. Controversy about therapeutic behavior in these patients with or without central neurological deficit is still under in discussion.


OBJECTIVE
To present a patient with acute carotid thrombosis due to a shotgun wound and discuss its therapeutic behavior.


METHODS
Hospital de Urgencias in Córdoba city.


METHODS
A 15-year-old male patient is presented with a "point-blank" shotgun wound in the soft parts of the left cervical region, and a left carotid thrombosis with no central neurological deficit.


RESULTS
Wound toilette and carotid revascularization by means of resection and venous by-pass with external carotid ligature was performed. The procedure was finished by delaging for plastic reconstruction of the cervical injury. Carotid postoperative angiographic control showed good permeability with no carotid flow alteration.


CONCLUSIONS
Penetrating carotid injuries should be resolved, if technically possible, with revascularization of the carotid sector. This procedure has to be aborted if the patient is in coma or the lesion is difficult to repair, in such a case ligature should be carried out.
Fuentes
Javier
J
Servicio de Cirugia-Sección Cirugía Vascular, Cátedra de Emergentología, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Argentina. jjavierfuentes@Hotmail.com
Montenegro
Rolando
R
Casaretto
Eduardo
E
Quelas
Jorge
J
Procikieviez
Oscar
O
Canga
Carlos
C
Florez Nicolini
Francisco
F
D000208:Acute Disease; D000293:Adolescent; D000792:Angiography; D002341:Carotid Artery Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D014948:Wounds, Gunshot / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*