RESUMO
<b>Objective</b> : Blunt aortic injury often accompanies other organ injuries, and therefore requires an appropriate lifesaving surgical strategy. <b>Patients</b> : During the past 8 years, blunt aortic injury was reviewed, based on 5 lifesaving cases experienced in our hospital. There were 3 men and 2 women (aged 57-70, average 64.2). The Injury Severity Scores were 13-25 (an average of 17.2). <b>Intervention</b> : Regarding our strategy, stabilization of vital signs should be at first aimed by intensive primary care, concomitantly with diagnostic procedures. When stabilization of vital signs is obtained, a delayed operation would be considered after damage control resuscitation. As for 3 of these 5 cases, an emergency surgery was performed because of distinct aortic hemorrhage with instability of vital signs, and stent graft repair was applied based on anatomical indication in two cases. In the other 2 cases, primary diagnosis suggested aortic injury by the bone fracture pieces. Damage control was conducted following stabilization of vital signs, and delayed surgery was done with removal of the bone fracture pieces and repair of aortic injury, which improved activities of daily living. <b>Results</b> : All cases recovered with no particular complication, and were discharged on 9-32 days average postoperatively. <b>Conclusion</b> : Blunt aortic injury is often fatal, but the appropriate diagnosis and treatment can play an important role in obtaining the good results.
RESUMO
A 36-year-old man was transported to our hospital with severe anterior chest and abdominal pain of sudden onset which was diagnosed as Stanford type B acute aortic dissection with visceral ischemia. Aortogram revealed occlusion of celiac, superior mesenteric and inferior mesenteric arteries with aortic dissection. At first, fenestration of the abdominal aorta above the inferior mesenteric artery was immediately carried out, but the abdominal pain continued. Therefore, bypass grafting for the superior mesenteric artery with saphenous vein was performed the next day. The patient's postoperative course was complicated with acute renal failure and paralytic ileus, which were treated medically and he was discharged in good condition.