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14 December 2019 : Case report  USA

Ballistic Axillary Vein Transection: A Case Report

Management of emergency care

Saamia Shaikh1ABCDEF, Dessy Boneva12ABCDEF, Shaikh Hai1CDEF, Mark McKenney12BCDEF, Adel Elkbuli1ABCDEF*

DOI: 10.12659/AJCR.919090

Am J Case Rep 2019; 20:1869-1873

Abstract

BACKGROUND: Axillo-subclavian vessel injuries were traditionally the result of combat-related trauma encountered by military surgeons. An increase in gun-related violence in our backyards, however, have brought these injuries to our doorsteps. The majority of the available data explores the management of arterial injuries. There is a deficiency in the literature discussing the management of isolated axillo-subclavian venous injuries.

CASE REPORT: We report the case of a 25-year-old male who presented after sustaining a gunshot wound to his right lateral chest and axillary area. Computed tomography angiography revealed axillary vein transection. Upon emergent operative intervention, vascular control of the hemorrhage was achieved with ligation of the axillary vein. The patient had an uncomplicated postoperative course and follow up in the office was unremarkable.

CONCLUSIONS: Axillo-subclavian vessel injuries can result in exsanguination and are associated with a significant mortality risk. Early detection and expeditious management are essential for preserving the patient’s limb and preventing the loss of life. Isolated axillary vein injuries can be managed in an unstable patient with ligation and is well-tolerated by patients with an evanescent upper extremity edema.

Keywords: Axillary Vein, Subclavian Vein, Treatment Outcome, Wounds, Gunshot, Adult, computed tomography angiography, Ligation

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923