Jurado Pedro Ramos, Aragón Fernando Hernández, González Víctor Aaron Miranda, Silva Jesús Antonio Loya, Gutiérrez Edgar Azael Pérez, Ortiz Nadia Karina Portillo, Vázquez Adriana Cristina Quintana, Venzor Luisa Fernanda Trujillo, Aponte Eduardo Enrique Gámez, Madrid Arturo Aguirre, Nafarrate Edmundo Berumen
Department of Orthopedic Surgery, Christus Muguerza del Parque Hospital, De la Llave Street No. 1419, Office 9, Col. Centro, Chihuahua 31000, Mexico.
Department of Angiology and Vascular Surgery Hospital Ángeles Chihuahua (CIMA Hospital), C. Haciendas del Valle 7120-Interior 21, Haciendas del Valle III, Chihuahua, 31217 Chih, Mexico.
Case Rep Orthop. 2023 Aug 11;2023:8918724. doi: 10.1155/2023/8918724. eCollection 2023.
Aortic dissection is a life-threatening acute condition characterized by the separation of the aortic wall's layers. It is caused by a tear in the internal vascular wall (intimal layer and middle layer), which results in bleeding between the layers and causes abrupt and excruciating pain. The appropriate consideration must be given to the condition's dynamic nature, and variations in clinical presentation, without neglecting the urgency for intervention. In this case study, a 65-year-old male engaged in a car accident is admitted to urgent care with a traumatic aortic dissection diagnosis that included the aortic arch, a segmental exposed fracture of 1/3 distal of the right femur AO 32C3k, and an intertrochanteric fracture AO 31A1.3. The patient developed transient paraplegia as the initial manifestation of acute aortic dissection, which represents a high mortality and morbidity entity without adequate and prompt treatment, and prompt diagnosis and management were critical. A patient with severe thoracic and abdominal trauma caused by high-energy injury should be properly evaluated for the possibility of traumatic aortic dissection. The endovascular aortic repair was performed, resulting in a positive clinical evolution due to the important participation of the multidisciplinary trauma team involved in patient management and prompted decision-making.
主动脉夹层是一种危及生命的急性病症，其特征是主动脉壁各层分离。它由血管内壁（内膜层和中层）撕裂引起，导致层间出血并引发突发剧痛。必须充分考虑该病症的动态特性以及临床表现的差异，同时不能忽视干预的紧迫性。在本病例研究中，一名65岁男性因车祸入院接受紧急治疗，诊断为创伤性主动脉夹层，累及主动脉弓，右股骨远端1/3处有AO 32C3k节段性开放性骨折，以及转子间骨折AO 31A1.3。患者最初表现为急性主动脉夹层导致的短暂性截瘫，若未得到充分及时的治疗，这是一种死亡率和发病率都很高的病症，因此及时诊断和处理至关重要。因高能损伤导致严重胸腹部创伤的患者应接受适当评估，以确定是否存在创伤性主动脉夹层的可能性。实施了血管腔内主动脉修复术，由于多学科创伤团队积极参与患者管理和迅速决策，临床病情呈积极进展。
