Emergency surgery for vascular injury

Some wounds are so deadly that the patient may lose his/her life if the surgery gets delayed.

Today, in this article, you’ll learn about such vascular injuries or traumas, which require immediate surgery. 

What is Vascular Injury?

The term Vascular Injury refers to an injury of artery, vein, or blood vessels. 

Profoundly and severe injuries can damage the affected artery or vein. 

They play a vital role in the human body.  

Arteries carry blood from the heart and supply it to the other parts of the body, and veins bring back the blood towards the heart.

In medical language, vascular injury is known as vascular trauma. 

Vascular traumas are dangerous, and if left untreated for a longer period, they can be fatal. Some vascular injuries are so life-threatening that they require immediate surgery.

What causes vascular injury?

Numerous factors can be responsible for vascular injury.  

Penetrating wounds cause Vascular injuries. Penetrating trauma refers to injuries or damages caused by an object that penetrates the skin, such as a gunshot, stabbing wound, or a deep wound caused by sharp objects like a knife, broken glass, etc. However, the majority of vascular injuries occur due to severe accidents such as car accidents, falls, athletic injuries, violent crimes, bomb blast.

Symptoms of Vascular Injury 

Here, are some common symptoms of Vascular injury-

  • Heavy blood loss
  • Fractured bones
  • Bruising 
  • Swelling
  • Scarring
  • Soreness 
  • Formation of a blood clot

Diagnosis 

Vascular injuries can be diagnosed by several invasive and noninvasive tests.

Invasive tests

  • Angiography
  • DSA (Digital Subtraction Angiography)
  • MRA (Magnetic Resonance Angiography)
  • Venography

Noninvasive tests

  • Duplex ultrasound 
  • B-mode ultrasound
  • Doppler ultrasound (colour flow)
  • Handheld doppler
  • CT Scanning.
  • Ankle Brachial Index (ABI)

Emergency surgery for vascular injury

Vascular trauma can be mild, moderate, or severe. Some vascular lesions go away on their own after a long period of time, while some severe instances require immediate surgery.  

Major vascular traumas should be treated within 6-8 hours, and if the patient does not get treatment promptly, the patient may lose his life or limb. 

Here are some of the vascular trauma that requires emergency surgery. 

Peripheral vascular injury 

The peripheral vascular injury refers to the damages that occurred in the main arteries and veins due to which the arteries and veins are not able to supply oxygen-rich blood all over the body, and this can be resulting in loss of limb or life. 

If treatment is not given immediately, then the arteries and veins can get damaged permanently, or the patient may expire. 

Thoracic aorta injury 

Thoracic aorta injury refers to the damage caused in the aorta artery, which lies in the chest cavity. Mostly, it is caused due to accidents or penetrating trauma. 

It is challenging to detect through signs and symptoms because it hardly shows any signs. 

Through physical exams and tests can detect the problem.  

Vascular Spasm

In vascular spasm, the blood vessels suddenly get tightened and cause intense pain.

The tightening of the blood vessel reduces the blood flow, and sometimes it completely restricts the flow of blood. When the oxygenated blood doesn’t reach its targeted area, the tissues of that area get affected. 

Intimal flap

Any severe blunt trauma can lead to intimal flap or wall defect in an artery. 

The lesion requires immediate surgical resection or iridectomy. 

Arteriovenous fistula (A-V fistula)

An arteriovenous fistula is an unusual condition between an artery and a vein. 

Normally, blood flows from arteries to capillaries, and then blood reaches in the veins, but in Arteriovenous fistula condition, the blood directly flows in the veins from the arteries. So, in this condition, the capillaries receive very little blood.  

This condition can develop anywhere in the body, but mostly it occurs in the legs. 

Aneurysm

Aneurysm refers to the condition when an artery gets enlarged due to weakening or bulging in the artery wall.  

A ruptured aneurysm is fatal, and if an aneurysm gets ruptured before treatment, the patients will lose their life. 

They don’t show any early signs & symptoms, and when they reach their final stage, they start showing some symptoms, But before the patient can understand what is happening and why the aneurysm ruptures and the patient dies.

An aneurysm can affect any artery, but it mostly affects the body’s main artery that serves the brain and heart.

Pseudoaneurysm

Pseudoaneurysms refer to the accumulation of blood between two outer layers of an artery.

Blood begins to accumulate when the walls of an artery are injured, and the blood starts leaking. 

If it is left untreated, it can lead to more severe conditions such as deep vein thrombosis or Pseudoaneurysm can get ruptured. 

Arterial embolism

Arterial embolism refers to a condition in which blood flow suddenly disrupts due to an embolus (blood clot). 

Blood clots generally occur in the legs, arms or feet. 

Several factors can be responsible for the development of embolism, such as hypertension, smoking, heart disease, any injury or surgery of the artery. 

These are some vascular injuries that need to be treated as soon as possible to prevent any permanent damage, loss of limb, loss of life.   

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