Case report
Late Aortic Injury: A Rare Complication of a Posterior Rib Fracture

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Traumatic rib fractures are common and are often associated with a hemothorax or pneumothorax. Rib fractures can also be a marker of severe trauma, and aortic transection is a well-described cause of death, particularly after a deceleration injury. However, direct aortic laceration by a fractured rib segment is extremely rare. We describe the late presentation of such a case and discuss the possible mechanism of injury.

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Comment

Thoracic trauma is present in 10% to 15% of all trauma cases and is responsible for approximately 25% of trauma-related deaths [4]. Rib fractures represent the most frequent chest injury [5] with an incidence reported to range between 7% and 40% [4]. However, the true incidence is not known, as up to half of these fractures are missed on standard chest roentgenograms [6]. The elderly are particularly susceptible to complications, and a larger number of rib fractures is associated with a higher

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Copyright © 2009 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.