Citation

Mohammadi SF, Samimi P, Mohammadi SM, Soroush AR, Hedges JR. Ulus. Travma Acil Cerrahi Derg. 2010; 16(3): 271-274.

Affiliation

Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran; Center for Academic and Health Policy, Tehran University of Medical Sciences, Tehran University of Medical Sciences, Tehran University of Medical Sciences, Tehran.

Copyright

(Copyright © 2010, Ulusal Travma ve Acil Cerrahi Dernegi)

DOI

unavailable

PMID

20517756

Abstract

We aimed to present herein the case of a potentially preventable death involving traumatic aortic rupture and to develop a critical pathway for the management of isthmic aortic ruptures consistent with the available resources. A retrospective record review by a multidisciplinary panel of experts was done, and the probability of survival was estimated based on the Revised Trauma Score and Injury Severity Scale score. Literature review and expert consensus were used in a quality and safety analysis to develop a critical care pathway for future cases. A 32-year-old man, injured in a motorcycle accident, was referred to a trauma center in a state of shock. Thoracic aortic rupture was highly suspected. For educational purposes, the classic signs of a widened mediastinum, right tracheal deviation, and left-sided hemothorax (in a context of significant deceleration injury) are incorporated into an acute care triad for traumatic aortic rupture. In such cases, in the absence of poor access to aortography, we suggest (serial - if needed) contrast-enhanced chest computed tomography scanning for diagnosis confirmation and operative planning. Assumption of hemodynamic stability can be catastrophic, and transferring the patient to a second facility may endanger survival, when operative capacity exists at the initial trauma facility.

Language: en