title: Assessment of internal mammary artery injury after blunt chest trauma: a literature review.
abstract: The occurrence, bleeding, and treatment of internal mammary artery (IMA) injury after blunt chest trauma have not been well described in the literature. We reviewed articles published from July 1977 to February 2014 describing IMA injury after blunt chest trauma in 49 patients. There was a predominant incidence in males and on the left side. Blunt trauma to the IMA can cause anterior mediastinal hematoma, hemothorax, pseudoaneurysm, arteriovenous fistula, and extra-pleural hematoma. Of the 49 patients studied, 20 underwent embolization, 22 underwent surgical operation, 4 were managed by clinical observation, and 3 had undescribed treatment. Different parts and extents of IMA injury, adjacent vein injury, as well as the integrity of the pleura determined differences in bleeding modality. Prompt diagnosis, complete hemostasis, aggressive resuscitation, and multidisciplinary teams are recommended for patients with IMA injury.
authors.affiliation: Department of Emergency Medicine, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China; Department of Emergency Medicine, Zhejiang Hospital, Hangzhou 310053, China; Department of Thoracic Surgery, the Affiliated Hospital, School of Medicine, Qingdao University, Qingdao 266003, China.
authors.forename: Jin-ming
authors.initials: JM
authors.lastname: Chen
authors.forename: Jin
authors.initials: J
authors.lastname: Lv
authors.forename: Kai
authors.initials: K
authors.lastname: Ma
authors.forename: Jing
authors.initials: J
authors.lastname: Yan
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015984:Causality; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008323:Mammary Arteries / Q000293:injuries*; D008875:Middle Aged; D018570:Risk Assessment; D017678:Sex Distribution; D013898:Thoracic Injuries / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D057772:Vascular System Injuries / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy
keywords: Bleeding; Blunt chest trauma; Internal mammary artery injury; Treatment