nmpЖурнал им. Н.В. Склифосовского «Неотложная медицинская помощь»Russian Sklifosovsky Journal "Emergency Medical Care"2223-90222541-8017“N.V. Sklifosovsky Research Institute for Emergency Medicine”10.23934/2223-9022-2022-11-2-280-286nmp-1414Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESОсобенности диагностики и лечения спонтанных внеорганных гематом мягких тканей шеи и грудиFeatures of Diagnosis and Treatment of Spontaneous Extraorganic Hematomas of the Soft Tissues of the Neck and Chesthttps://orcid.org/0000-0002-7088-8645ВладимироваЕ. С.VladimirovaE. S.

Владимирова Елизавета Семеновна, доктор медицинских наук, научный консультант

Российская Федерация, 129090, Москва, Б. Сухаревская пл., д. 3

Elizaveta S. Vladimirova, Doctor of Medical Sciences, Scientific Consultant

B. Sukharevskaya Sq., Moscow, 107045, Russian Federation

prizma06@yandex.ruТарабринЕ. А.TarabrinE. A.

Тарабрин Евгений Александрович - доктор медицинских наук, заведующий научного отделения

Российская Федерация, 129090, Москва, Б. Сухаревская пл., д. 3

Evgeny A. Tarabrin - Doctor of Medical Sciences, Head

B. Sukharevskaya Sq., Moscow, 107045, Russian Federation

t_evg_a@mail.ruhttps://orcid.org/0000-0002-5798-1407ПоповаИ. Е.PopovaI. E.

Попова Ирина Евгеньевна - кандидат медицинских наук, старший научный сотрудник отделения лучевой диагностики

Российская Федерация, 129090, Москва, Б. Сухаревская пл., д. 3

Irina E. Popova - Candidate of Medical Sciences, Senior Researcher

B. Sukharevskaya Sq., Moscow, 107045, Russian Federation

popovaie@sklif.mos.ruhttps://orcid.org/0000-0003-1945-323XПопугаевК. А.PopugayevK. A.

Попугаев Константин Александрович - доктор медицинских наук, заместитель директора – руководитель регионального сосудистогоцентра

Российская Федерация, 129090, Москва, Б. Сухаревская пл., д. 3

Konstantin A. Popugaev - Doctor of Medical Sciences, Deputy Director - Head of the Regional Vascular Center

B. Sukharevskaya Sq., Moscow, 107045, Russian Federation

stan.popugaev@yahoo.comhttps://orcid.org/0000-0003-2039-5604КрамаренкоА. И.KramarenkoA. I.

Крамаренко Анатолий Игоревич - врач по рентгенэндоваскулярным диагностике и лечению

Российская Федерация, 129090, Москва, Б. Сухаревская пл., д. 3

Anatoly I. Kramarenko - Physician for X-ray Endovascular Diagnosis and Treatment of the Department of X-ray Surgical Methods of Diagnosis and Treatment

B. Sukharevskaya Sq., Moscow, 107045, Russian Federation

kramarenkoai@sklif.mos.ruОтделение торакальной хирургии ГБУЗ «Научно-исследовательский институт им. Н.В. Склифосовского ДЗМ»РоссияDepartment of Thoracic Surgery N.V. Sklifosovsky Research Institute for Emergency MedicineRussian Federation202208092022112280268Copyright © Владимирова Е.С., Тарабрин Е.А., Попова И.Е., Попугаев К.А., Крамаренко А.И., 20222022Владимирова Е.С., Тарабрин Е.А., Попова И.Е., Попугаев К.А., Крамаренко А.И.Vladimirova E.S., Tarabrin E.A., Popova I.E., Popugayev K.A., Kramarenko A.I.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jnmp.ru/jour/article/view/1414

Показаны возможности компьютерной томографии в диагностике спонтанных гематом (СГ) мягких тканей шеи и груди и особенности их лечения. Компьютерная томография с внутривенным болюсным контрастным усилением является основным методом диагностики СГ, позволяющим указать точную ее локализацию, распространение, определить структуру и объем гематомы, выход контрастного препарата за контуры сосуда и с учетом полученных данных и клиники определяет тактику лечения.

Стабильные СГ не требуют хирургического лечения. В случае наличия большого объема гематомы груди, компрессионного синдрома, гемоторакса - показано дренирование. Нестабильные СГ, диктуют необходимость выполнения ангиографии и при необходимости эндоваскулярной эмболизации.

The possibilities of computed tomography in the diagnosis of spontaneous hematomas (sh) of the soft tissues of the neck and chest and the features of their treatment are shown. Computed tomography with intravenous bolus contrast enhancement is the main method for diagnosing sh, which allows you to specify its exact localization, distribution, determine the structure and volume of the hematoma, the contrast agent exiting the contours of the vessel, and, taking into account the data obtained and the clinic, determines the tactics of treatment.

Stable sh does not require surgical treatment. In the case of a large volume of chest hematoma, compression syndrome, hemothorax, drainage is indicated. Unstable sh dictate the need for angiography and, if necessary, endovascular embolization.

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The authors declare that there are no conflicts of interest present.