TWO BLUNT THORACIC AORTIC LESIONS IN POLYTRAUMA : A CASE REPORT

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  • NAKAYAMA Fumihiko
    Nippon Medical School Chiba Hokusoh Hospital, Shock and Trauma Center
  • ICHIKAWA Yoriko
    Nippon Medical School Chiba Hokusoh Hospital, Shock and Trauma Center
  • SAKAMOTO Taigo
    Nippon Medical School Chiba Hokusoh Hospital, Shock and Trauma Center
  • OKADA Kazuhiro
    Nippon Medical School Chiba Hokusoh Hospital, Shock and Trauma Center
  • SEO Takao
    Nippon Medical School Chiba Hokusoh Hospital, Shock and Trauma Center
  • HATTORI Yo
    Nippon Medical School Chiba Hokusoh Hospital, Shock and Trauma Center
  • YASUMATSU Hiroshi
    Nippon Medical School Chiba Hokusoh Hospital, Shock and Trauma Center
  • MOTOMURA Tomokazu
    Nippon Medical School Chiba Hokusoh Hospital, Shock and Trauma Center
  • IIDA Hiroaki
    Nippon Medical School Chiba Hokusoh Hospital, Shock and Trauma Center
  • MASHIKO Kazuki
    Nippon Medical School Chiba Hokusoh Hospital, Shock and Trauma Center
  • SAITOH Nobuyuki
    Nippon Medical School Chiba Hokusoh Hospital, Shock and Trauma Center
  • YAGI Takanori
    Nippon Medical School Chiba Hokusoh Hospital, Shock and Trauma Center
  • HARA Yoshiaki
    Nippon Medical School Chiba Hokusoh Hospital, Shock and Trauma Center
  • MATSUMOTO Hisashi
    Nippon Medical School Chiba Hokusoh Hospital, Shock and Trauma Center

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Other Title
  • ２ヵ所の胸部大動脈損傷を含む多発外傷の一例

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<p>　　A 42-year-old man was brought to our trauma center in hemorrhagic shock caused by a motorcycle accident. We diagnosed left diaphragm injury with evisceration into the thoracic cavity, unstable pelvic fracture, and right femur fracture. First, transcatheter arterial embolization and external fixation were performed for the pelvic fractures, and the diaphragm injury was repaired for respiratory stabilization. A computed-tomography scan revealed two thoracic aortic lesions. As we found no extravasation of contrast media, we continued careful observation. On hospital day 16, thoracic endovascular aortic repair (TEVAR) was performed for the isthmus injury. A follow-up computed tomography scan indicated enlargement of the arch injury. Therefore, total arch replacement was performed on hospital day 24. Both TEVAR and thoracotomy are necessary for the management of multiple lesions due to blunt thoracic aortic injury.</p>

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