Lesión de arteria subclavia izquierda en trauma cerrado de tórax: presentación de caso clínico quirúrgico

The attention to the persons with varied traumatisms has to be made by a multiple disciplines team, that under the direction of the General Surgery Team and the Intensive Care Team, could guarantee the permeability of the respiratory tract and the stabilisation of the cardio-circulatory dynamic in situations of emergency. This team also requests from other surgical specialitys like Anaesthesia, Vascular Surgery and Traumatology their assessments about the situation. It is necessary the stabilisation of the cardio-circulatory dynamics, a diagnosis orientation using the clinical method, the anamnesis and the physical examination of the person with varied traumatisms. Afterwards it will be done a thorax X-ray, an abdominal puncture and the medical Team would value the need of other diagnostics methods. In this work the authors present the surgical clinical intervention made and the results obtained when attending a person with varied traumatisms by car accident  in a motorcycle and that was attende d in the hospital of the IESS of Ibarra, Ecuador, in September of the 2015. The person suffered an impact with bruise of the left hemithorax, extra pleural, from the left supraclavicular region until the axillary region. Besides he suffered acute arterial isquemia of his left upper member and fracture of femur and tibia in his left leg. He presented hypovolemic shock. The t am established the clinical diagnostic of injury of left subclavian artery secondary to traumatic fracture of first rib, and the need of surgery of emergency with the aim to save the life and avoid the loss of the left upper member