Baba M, Yamashita A, Sugimoto S, Izumiyama O, Hasegawa T
Department of Cardiovascular Surgery, Hakodate Municipal Hospital, Hakodate, Japan.
Kyobu Geka. 1998 Sep;51(10):860-3.
We report a case of traumatic thoracic aortic aneurysm found by occurrence of pulmonary atelectasis in the chronic phase. The patient, an 18-year-old female, was hospitalized with multiple trauma caused by a traffic accident. At the time of hospitalization, no thoracic trauma was found but a fracture of the pelvis and one leg was recognized. 45 days after the initial trauma, a pulmonary atelectasis on the left lung was found on a chest X-ray film. By chest CT and angiography, the pulmonary atelectasis was proved to be caused by compression of the left main bronchus by a traumatic aneurysm of the thoracic aorta. 55 days after the initial trauma, resection of the aneurysm and graft replacement was performed. Postoperative course was satisfactory. In conclusion, possibility of an injury to the thoracic aorta should be considered on the treatment for the patient with multiple trauma in the chronic phase as well as in the acute phase.
我们报告一例在慢性期因肺不张而发现的创伤性胸主动脉瘤病例。患者为一名18岁女性,因交通事故导致多处创伤而住院。住院时,未发现胸部创伤,但发现骨盆和一条腿骨折。初次创伤45天后,胸部X线片发现左肺肺不张。通过胸部CT和血管造影,证实肺不张是由胸主动脉创伤性动脉瘤压迫左主支气管所致。初次创伤55天后,进行了动脉瘤切除和人工血管置换术。术后病程顺利。总之,在治疗慢性期以及急性期的多发伤患者时,应考虑胸主动脉损伤的可能性。