Kono T, Nakano H, Goto H, Nakajima T, Amano J
Department of Surgery, Shinsyu University School of Medicine, Matsumoto, Japan.
Jpn J Thorac Cardiovasc Surg. 1998 Oct;46(10):1000-3. doi: 10.1007/BF03217862.
A case of complete circumferential rupture of the thoracic aorta due to blunt chest trauma is presented. A 30-year-old man was admitted after a traffic accident. The admission chest X-ray film demonstrated mediastinal widening. About 6 hours after the traffic accident, chest CT scanning demonstrated mediastinal hematoma, left pleural effusion and partial aortic dissection. Diagnoses of aortic rupture and liver injury were made, and surgery for the thoracic aorta was performed immediately. The aorta was found to be completely disrupted for the length of 2 cm, and a vascular prosthesis was interposed between the two ends of the aorta under partial cardiopulmonary bypass. We conclude that the enhanced chest CT scanning is helpful for diagnosis, and that if other organ injuries are not severe, the emergency operation should be performed.
本文报道一例因钝性胸部创伤导致胸主动脉完全环形破裂的病例。一名30岁男性在交通事故后入院。入院时胸部X线片显示纵隔增宽。交通事故后约6小时，胸部CT扫描显示纵隔血肿、左侧胸腔积液及部分主动脉夹层。诊断为主动脉破裂和肝损伤，立即进行胸主动脉手术。发现主动脉在2厘米长度范围内完全断裂，在部分体外循环下于主动脉两端置入血管假体。我们得出结论，增强胸部CT扫描有助于诊断，并且如果其他器官损伤不严重，应进行急诊手术。
