A case of chronic traumatic aneurysm of the descending thoracic aorta.

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A case of chronic traumatic thoracic aneurysm of the descending thoracic aorta after a blunt chest injury, which is relatively rare, is reported. A 26-year-old woman who had been suffering from major depression attempted suicide by felling from seventh floor on May 3, 1998. She had multiple injuries including multiple costal fractures, bilateral hemothoraxes, pelvic fracture, and ruptured bladder. Conservative treatments such as transfusion and chest tube drainage were conducted initially. On May 22, she was operated on to repair the pelvic fracture and ruptured bladder. She had two other operations because of pelvic osteomyelitis. A routine chest X-ray examination on November 5 demonstrated an enlargement of the aortic notch. Enhanced CT scan revealed an aneurysm of the descending thoracic aorta. On December 1, she underwent a resection of the aneurysm and a prosthetic graft replacement. The postoperative course was uneventful. Traumatic rupture of the thoracic aorta demands prompt diagnosis and surgical therapy. It is rare that such a patient can escape from death due to the rupture in an acute phase and thereafter an aneurysm of the thoracic aorta is formed chronically like our case. In instances in which rupture of chronic traumatic thoracic aneurysms occur, surgery is recommended immediately after making the diagnosis.
日本臨床外科学会の論文