A Case of Traumatic Dissecting Femoral Artery Occlusion with ARDS, MNMS and Sepsis Noriyuki Takahashi 1 , Soichi Sasajime 2 , Sumito Sato 3 , Koji Nakanishi 4 , Sigeru Tagaki 5 1Department of Thoracic Surgery, Eniwa Daiichi Hospital 2Department of Surgery, Eniwa Daiichi Hospital 3Department of Cerebral Surgery, Eniwa Daiichi Hospital 4Department of Internal Medicine, Eniwa Daiichi Hospital 5Department of Respiratory Medicine, Mimamiichijyo Hospital Keyword: 外傷性解離性大腿動脈閉塞症 , MNMS , 成人呼吸窮迫症候群 , traumatic dissecting femoral artery occlusion , ARDS pp.1217-1221
Published Date 1995/12/15
DOI https://doi.org/10.11477/mf.1404901167
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A 26-yerar-old man, who had been injured seriously in a traffic accident, was admitted to our hospital. At that time his condition developed into shock caused by profuse bleeding, and his consciousness was marked by confusion with occasional tonic spasm.

At first we performed an operation for hemostatis on the left femoral vein under the region of the injury. Buthis left dorsal pedis artery was not palpable and arterial bleeding was increasing. Because of this a second operation was performed and an extra-anatomic by-pass with 6 mmΦ Gore-Tex graft for traumatic dissect-ing of the femoral artery, and a hemostatis on the left femoral artery were carried out. Three days after the injury, his condition showed complicated MNMS because serum CK rose until 58069 U/ml. Eleven days after injury, he was attacked of hypoxemia (P02 25.7 mmHg) owing to ARDS. And 19 days after the injury, he came to need hemodialysis because of the increase ofBUN (127 mg/dl).

Steroid (methylprednisolone) and artificial respira-tion with PEEP were efficacious against ARDS. Hemodialysis was efficacious against renal insufficiency as a result of MNMS. And Vancomycin and Chloran-phenicol were useful for sepsis (maximum WBC: 33,500/mm3, Endotoxin test : 217.8 pg/ml) probably caused by Pseudomonas cepacia.

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