Traumatic rupture of the thoracic aorta. A clinicopathological study.
In a county hospital serving a population of roughly 240,000, the hospital records from the period 1982 to 1987 included 27 patients who presented with traumatic rupture of the thoracic aorta. Eighteen patients died instantaneously, one was dead on admission, five died in hospital and three survived operation. Two patients had direct cross clamping of the aorta and Dacron interposition graft soon after admission; both survived. The third patient had a Gott shunt and Dacron interposition graft the day after the accident and survived with paraplegia. In all patients who died in hospital except one, the condition was not diagnosed before death. We conclude that traumatic rupture of the thoracic aorta occurs more frequently than is generally thought. Although most patients die at the scene of the accident, a liberal use of angiography is indicated in all trauma cases admitted to hospital with a history of a forceful deceleration or acceleration injury.