Ultrasound diagnosis of firearm damage to major arteries of the neck

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Background. The presence of large vessels, many vital structures, and the lack of protection make the neck particularly vulnerable to various injuries, including gunshot wounds. The purpose was to evaluate the possibilities of ultrasonography in the diagnosis of gunshot injuries of the major arteries of the neck. Materials and methods. The analysis of the ultrasonography results in diagnosis of gunshot injuries to the large vessels of the neck in 53 injured persons was carried out. Visualization of the large vessels of the neck was carried out using linear and microconvex sensors in the frequency range of 5–10 and 4–9 MHz on the Philips HD11 device. Results. Damage to the common carotid artery was recorded in 38 cases, the internal carotid artery — in 23, the external carotid artery — in 21, the subclavian artery — in 24, the vertebral artery — in 15. The following types of damage were detected: intimal tear with flap formation in 27 cases, detachment of the intima in 45, pseudoaneurysm in 49 cases. A statistically significant difference (P < 0.01) was found between the number of pseudoaneurysms and intimal tear with flap formation (P < 0.01). Among injuries of the common carotid artery, pseudoaneurysm occurred significantly more often than intimal tear with flap formation (P < 0.01) and intimal detachment (P < 0.05). Damage to the common carotid artery was diagnosed statistically significantly more often than to the internal carotid artery (P < 0.05) and external carotid artery (P < 0.01), subclavian artery (P < 0.05), and vertebral artery (P < 0.001). Conclusions. Ultrasonography makes it possible to detect damage to all major arteries of the neck sustained due to combat trauma. Pseudoaneurysms statistically reliably prevail over intimal tear with flap formation and cervical artery dissection. Ultrasonography has sufficient sensitivity (87.8 %), specificity (60.9 %) and accuracy (82.6 %) in the diagnosis of gunshot injuries of the major arteries of the neck, as well as pseudoaneurysm (93, 75, 90.2 %, respectively).