S45.012

Clinical Causes: Trauma from falls, accidents, or sports injuries that impact the shoulder or upper arm Penetrating injuries such as stab or gunshot wounds in the armpit area Surgical procedures around the shoulder or upper chest that inadvertently damage the artery Severe blunt force trauma from vehicular accidents or industrial incidents Extreme stretching or dislocation of the shoulder following a traumatic event

Key Symptoms: Severe bleeding from the wound in the armpit area Swelling and bruising around the shoulder and upper arm Pain that is sudden, intense, and persistent in the shoulder or arm Weakness or numbness in the affected arm Signs of shock, such as pale, clammy skin, rapid heartbeat, and dizziness Reduced or absent pulse in the affected arm

Diagnosis Path: Healthcare providers typically use a combination of the patient’s medical history and physical examination to assess injury severity. Diagnostic tests may include: - **Physical examination** focusing on blood flow, wound assessment, and neurological function - **Ultrasound** to evaluate blood flow and detect blood vessel damage - **Doppler imaging** for detailed visualization of circulation - **Angiography** — an imaging test using X-ray and contrast dye to visualize blood vessels and pinpoint the injury - **X-rays** to assess for associated fractures or dislocations in the shoulder or upper arm Prompt diagnosis is crucial to prevent complications such as ongoing bleeding, blood loss, or limb ischemia (lack of blood supply).

Treatment Protocols: Treating a laceration of the axillary artery generally involves emergency intervention and surgical repair. Treatment options include: - **Hemorrhage control**: Immediate efforts to stop bleeding, which may include applying pressure or tourniquets - **Surgical repair**: Closing the damaged artery using sutures or grafts to restore blood flow - **Blood transfusions**: To replace lost blood and stabilize the patient - **Management of associated injuries**: Addressing any additional damage to bones, nerves, or muscles - **Postoperative care**: Monitoring for signs of infection, ensuring proper wound healing, and assessing limb function In some cases, additional therapies such as anticoagulants may be prescribed to prevent blood clots, with physical therapy potentially necessary for recovery of arm mobility and strength. Recovery times vary depending on the severity of the injury and the success of the intervention.