Traumatic pseudoaneurysm from the aorta to the left common carotid artery presenting as widened mediastinum.
Diagnosis of pseudoaneurysm of the aorta or its main branches is a challenge in patients with blunt chest trauma. Computed tomography helps to demonstrate intrathoracic hemorrhage and suspected great vascular injury when a chest radiograph reveals widening of the mediastinum. Aortic angiography remains the gold standard in the determination of the site, and severity of vascular injury for definitive surgical intervention. Timing of surgical repair is controversial. Delayed repair of traumatic pseudoaneurysm of the aorta after primary control of associate injuries decreases mortality significantly, thus improving prognosis. We report a case of successful repair of a traumatic pseudoaneurysm of the aortic arch with extension to the left common carotid artery in an 18-year-old female patient. The diagnosis, surgical approaches, and timing of operation are discussed along with case presentation.
Chen
Shih-Yi
SY
Division of Thoracic Surgery, Department of Surgery, National Defense Medical Center, Taipei, Taiwan, ROC.
Chang
Hung
H
Lee
Shih-Chun
SC
Hsu
Hsian-He
HH
Tzao
Ching
C
D000063:Accidents, Traffic; D000293:Adolescent; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000601:surgery*; D001011:Aorta; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000601:surgery*; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008482:Mediastinum / Q000000981:diagnostic imaging* / Q000293:injuries*; D013898:Thoracic Injuries / Q000000981:diagnostic imaging*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging