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Peripheral Vascular Trauma
Karim Brohi, trauma.org 7:3, March 2002
Vascular injury has two main consequences - haemorrhage and ischaemia. Or, in the words of an anonymous Czech surgeon, "Bloody vascular trauma - it's either bleeding too much or it's not bleeding enough".
Unrecognised and uncontrolled haemorrhage can rapidly lead to the demise of the trauma patient. Unrecognised and untreated ischaemia can lead to limb loss, stroke, bowel necrosis and multiple organ failure. The aim of this article is to highlight the fundamentals of vascular trauma and provide an approach to the diagnosis and management of vascular injury.
Arterial and venous structures are most commonly injured by penetrating trauma, with a much higher incidence in gunshot wounds than for stab injury. Blunt trauma also carries a significant vascular injury rate, and iatrogenic vascular injuries are increasing with radiological and minimal access procedures becoming more commonplace.
trauma.org (7:3) March 2002