Akköse Sule, Bulut Mehtap, Cikriklar Halil Ibrahim, Armağan Erol, Ateş Mete
Department of Emergency Medicine, Medicine Faculty of Uludağ University, Bursa, Turkey.
Ulus Travma Acil Cerrahi Derg. 2004 Jan;10(1):57-9.
Aortic injuries can easily be missed in polytraumatized patients due to either associated injuries or vagueness of physical examination findings. Especially in young adults without associated injuries, relatively low atherosclerotic changes may limit the dissection of traumatic descending aortic injuries. We present a 34-year-old male patient who only had a complaint of back pain following a traffic accident. Upon detection of no abnormalities on plain X-ray films, he was discharged home with analgesics. One week later, he presented with dypsnea and dysphagia. Aortography showed rupture of the aorta and a pseudoaneurysm near the isthmus. Following surgical excision of the pseudoaneurysm and aortic repair with a Dacron graft interposition he was discharged with complete relief of symptoms. This case emphasizes the need for a high index of clinical suspicion in timely diagnosis and prompt treatment of traumatic aortic ruptures.
由于合并伤或体格检查结果不明确，多发伤患者的主动脉损伤很容易被漏诊。特别是在没有合并伤的年轻成年人中，相对较低的动脉粥样硬化改变可能会限制创伤性降主动脉损伤的夹层形成。我们报告一名34岁男性患者，他在交通事故后仅主诉背痛。在胸部X线平片未发现异常后，他带止痛药出院回家。一周后，他出现呼吸困难和吞咽困难。主动脉造影显示主动脉破裂及峡部附近假性动脉瘤形成。在手术切除假性动脉瘤并用涤纶补片进行主动脉修复后，他症状完全缓解出院。该病例强调了在创伤性主动脉破裂的及时诊断和迅速治疗中保持高度临床怀疑的必要性。
