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Reminder of important clinical lesson
CASE REPORT
Thoracic aortic transection resulting in a type B dissection following blunt trauma
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  1. Lance Fogleman1,
  2. Terrell Caffery1,
  3. Jeffrey Gruner2,
  4. Danielle Tatum3
  1. 1 Emergency Medicine, LSU Health Baton Rouge, Baton Rouge, Louisiana, USA
  2. 2 Trauma Specialist Program, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, USA
  3. 3 Division of Academic Affairs, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, USA
  1. Correspondence to Dr Terrell Caffery, tcaffe{at}lsuhsc.edu

Summary

A 39-year-old man sustained an acute grade III aortic injury resulting in a type B aortic dissection in the setting of severe traumatic brain injury, cervical spine injury and multiple orthopaedic injuries following a motorcycle crash. The patient underwent an emergent thoracic endovascular aortic repair, complicated by a thoracic pseudoaneurysm rupture and ongoing exsanguination from a persistent type 1 endoleak. Additional stent grafts were required to gain control of the endoleak. The patient ultimately progressed to brain death post procedure in the intensive care unit. This case reviews treatment considerations in the context of a blunt thoracic aortic transection and distal dissection with concomitant polytrauma.

  • trauma
  • resuscitation
  • trauma cns /pns
  • cardiothoracic surgery

https://doi.org/10.1136/bcr-2016-218766

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    Footnotes

    • Contributors LF, TC and JG were involved with patient care and worked together to draft the body of the case report. DT and LF drafted the introduction and discussion. All authors were involved in critically reviewing and revising the manuscript and preparing it for submission.

    • Competing interests None declared.

    • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

    • Provenance and peer review Not commissioned; externally peer reviewed.