Mimasaka Sohtaro, Yajima Yukihito, Hashiyada Masaki, Nata Masayuki, Oba Masatoshi, Funayama Masato
Department of Public Health and Forensic Medicine, Tohoku University School of Medicine, Sendai 980-8575, Japan.
Forensic Sci Int. 2003 Mar 12;132(1):5-8. doi: 10.1016/s0379-0738(02)00416-4.
A 74-year-old woman was struck by a car travelling at about 50 km/h. On arrival at hospital, a CT scan showed dissection of the ascending and descending aorta. She collapsed and died suddenly 8h later. At autopsy, there was massive bleeding into the left pleural cavity, ruptures of the pericardium and right ventricle, and a type A thoracic aortic dissection. The cause of death was haemorrhagic shock due to rupture of the pericardium and delayed rupture of the right ventricle following trauma to the chest. The thoracic aortic dissection was not the direct cause of death although histological examination did reveal that it occurred in the accident. Traumatic aortic dissection is rare although traumatic aortic rupture is a major cause of death after blunt chest trauma. This paper discusses the mechanisms, and factors involved in aortic dissection caused by blunt trauma.
一名74岁女性被一辆时速约50公里的汽车撞倒。入院时，CT扫描显示升主动脉和降主动脉夹层。8小时后，她突然晕倒并死亡。尸检发现左胸腔大量出血、心包和右心室破裂，以及A型胸主动脉夹层。死因是胸部外伤后心包破裂和右心室延迟破裂导致的失血性休克。尽管组织学检查确实显示胸主动脉夹层发生在事故中，但它并非直接死因。创伤性主动脉夹层很少见，而创伤性主动脉破裂是钝性胸部外伤后死亡的主要原因。本文讨论了钝性创伤引起主动脉夹层的机制及相关因素。
