Jo ur na l of Ac ad em ic Em er ge nc y M ed ici ne Ak ad em ik Ac il Tıp Olg u Su nu ml arı De rgi si
Introduction: Spontaneous subclavian artery injuries are extremely rare vascular emergencies. We aimed to present a case with subclavian artery transection after sneezing.Case Report: An 18-year-old male presented to the emergency department with the complaint of right shoulder pain after sneezing. His vital signs and physical examination were all normal. On the chest radiography, the mediastinal width was 7 cm. He was discharged. He presented to the emergency department after 5 hours from discharge with complaints of chest pain and dyspnea. He was hypotensive and tachycardic. Brachial and radial pulses were not palpable. A massive hemothorax was detected. Tube thoracostomy was performed, and his hemodynamic parameters deteriorated rapidly. Urgent thoracotomy was performed, and cardiac arrest occurred during the hemorrhage control. In the postmortem exploration, a complete subclavian artery transection was confirmed at the outlet of the arcus aorta. Conclusion:Sneezing is a minor trauma that precipitates spontaneous artery dissection. It was known that a mediastinal width of over 6 cm is associated with increased mortality. An advanced radiological assessment will be useful for patients who present to the emergency department with complaints of chest, back, shoulder, or arm pain after a sudden movement and have a mediastinal width of over 6 cm.
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