-Case Reports-

Visceral Ischemia Caused by Acute Aortic Dissection Following Blunt Aortic Injury: Report of a Case

Shigeki Kushimoto¹, Shin-ichiro Shiraishi², Masato Miyauchi², Reo Fukuda², Tomohiko Masuno² and Hiroyuki Yokota²

¹Division of Emergency Medicine, Tohoku University Graduate School of Medicine
²Department of Emergency and Critical Care Medicine, Graduate School of Medicine, Nippon Medical School

The diagnosis and management of blunt thoracic aortic injuries have seen significant changes over the last decade. The purposeful delay of definitive repair by aggressive blood pressure management has been suggested to be safe, and deliberate nonoperative management may be a reasonable alternative in selected patients with minimal aortic injuries detected with contrast-enhanced computed tomography. We report a case of acute aortic dissection due to blunt thoracic aortic injury resulting in splanchnic ischemia, for which we selected primarily nonoperative management, because the aortic tear was small but was complicated by multiple trauma. Although acute aortic dissection is an uncommon presentation of blunt injuries of the thoracic aorta and the poor prognosis has not been adequately emphasized, close observation, to evaluate the dissection and to determine whether splanchnic ischemia has developed, is recommended for patients for whom delayed definitive repair or nonoperative management has been selected.

J Nippon Med Sch 2011; 78: 110-115

Keywords
acute aortic dissection, blunt thoracic aortic injuries, blunt chest trauma

Correspondence to
Shigeki Kushimoto, MD, Division of Emergency Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi Aoba-ku, Sendai, 980-8574, Japan
kussie@emergency-medicine.med.tohoku.ac.jp

Received, October 18, 2010
Accepted, November 20, 2010