Okazaki Y, Kosako Y, Suenaga E, Shokyu Y, Nakayama Y, Itoh T
Department of Cardiovascular Surgery, Wajiro Hospital, Fukuoka, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Sep;42(9):1393-8.
We report two cases of acute traumatic transection of the descending thoracic aorta that were successfully treated. Case 1 (a 24-year-old male) was admitted to our hospital because of unconsciousness with multiple severe injuries including pelvic fracture, hepatic laceration, brain contusion, and multiple fractures in the extremities. An emergency operation was performed to control the active bleeding from the hepatic laceration and the transluminal arterial embolisation of the internal iliac arteries for the pelvic fractures. Since the condition of the patient was very serious, we had to wait the repairment of the thoracic aorta for 3 weeks. The operation was successful using extracorporeal circulation. Case 2 (a 22-year-old female) suffered traumatic transection of the descending thoracic aorta without other injuries and received an emergency operation, which was successful. The strategy for the treatment of an aortic transection is difficult, especially when involving multiple injuries. However provided the decision to operate takes careful account of the general condition of the patient, then a successful result might be obtained even in a very severe case.