title: Traumatic rupture of the thoracic aorta: time to diagnosis and treatment.
abstract: Survival of patients with traumatic rupture of the thoracic aorta (TRTA) depends on early surgical repair. Six cases of TRTA were treated at our institution in 7 years. Time to diagnosis was 1.5, 3, 4, 36, 91 and 140 hours (mean = 46 hours). Diagnosis was made by computed tomography in one and by angiography in five cases. Time from arrival to treatment was 3, 9, 5, 46, 117 and 152 hours (mean = 55 hours). All six patients were treated by clamp and suture technique, with a mean cross clamp time of 48 minutes. Significant delay in diagnosis and treatment occurred in three patients. The reasons for delay were unrecognized signs for TRTA on the initial chest X-ray, a false-negative result of transoesophageal echography and not considering the diagnosis of TRTA. The diagnosis of TRTA requires a high index of suspicion and should always be considered in victims of high impact trauma.
authors: Department of Surgery, University Hospital Vrije Universiteit, Amsterdam, The Netherlands.
authors: H W
authors: HW
authors: Willemsen
authors: F C
authors: FC
authors: Bakker
authors: P
authors: P
authors: Patka
authors: H J
authors: HJ
authors: Haarman
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D001019:Aortic Rupture / Q000000981:diagnostic imaging* / Q000601:surgery; D001027:Aortography; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging* / Q000601:surgery; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000601:surgery