Late haemorrhage from the subclavian vein due to a fracture of the first rib

Abstract

Lesions of the subclavian vessels due to closed chest injury are rare. Berga et all, reported during a five year period a 0.2 per cent incidence of lesions of the subclavian artery, in patients with closed chest injury. Pain and swelling were consistent findings in patients with traumatic lesions of the subclavian artery. Absence of peripheral pulsations or murmurs were occasionally found. In spite of severe damage of the subclavian arteryz, peripheral pulsations can be present because of extensive collateral circulafion of the upper extremity. Fractures of the clavicle, first rib or second rib, were found in all patients with lesions of the subclavian artery. A correlation between either the localisation of the rib fracture, or the degree of dislocation of the fragments and the occurrence of a lesion of the subclavian artery, has not been found3.