[Emergency operation for traumatic thoracic aortic rupture diagnosed by enhanced chest computed tomography; report of a case].

Thoracic aortic injury caused by blunt chest trauma is often fatal. Although aortography had been inevitable for thoracic surgery until recently, image of computed tomography (CT) is often superior to aortogram nowadays. We present a case of 64-yaer-old man with blunt chest trauma by traffic accident, who was successfully diagnosed and operated without invasive aortography. Thoracic aortic rupture was suspected by plain chest X-ray. His enhanced CT showed the localized leakage of contrast media near the arterial ligament of aortic arch. Because his condition was critically ill, operation was performed immediately without aortography. There found Y-shaped tear at the distal aortic arch, and was replaced with a prosthetic graft. Operation was performed under left heart bypass using heparin-coated circuit and centrifugal pump. We would stress that the enhanced chest CT is sufficiently diagnostic in thoracic aortic trauma like the present case.