THE DIAGNOSIS OF TRAUMATIC RUPTURE OF THE AORTA - 36 CASES

  • 1 January 1980
    • journal article
    • research article
    • Vol. 9  (38) , 2823-2827
Abstract
Cases (36) of traumatic rupture of the thoracic aorta (TRA) were diagnosed during the hours following the accident responsible. Rupture was situated at the aortic isthmus in 32 cases, the ascending aorta in 2 cases, the arch of the aorta in 1 case and the descending sub-isthmic aorta in 1 case. Ten patients had no rib fractures. In 16 patients not undergoing surgery before the 20th h after the trauma, 10 died of secondary rupture. The course of a TRA is unpredictable. It is of fundamental importance to make the diagnosis and undertake appropriate surgical treatment immediately. The essential clinical sign is a difference in blood pressure between the upper and low limbs (66%). Radiological signs suggestive of TRA are, in a chest film: widening of the mediastinum (92%), poor visibility of the knuckle of the aorta (89%), left hemothorax (67%), deviation of the trachea to the right (55%) and lowering of the left main bronchus (47%). The slightest suspicion of a TRA should lead to aortic angiography, preferably via an arterial approach (humeral or femoral) or intravenously. Surgical treatment should not be delayed.