title: Visceral ischemia caused by acute aortic dissection following blunt aortic injury: report of a case.
abstract: The diagnosis and management of blunt thoracic aortic injuries have seen significant changes over the last decade. The purposeful delay of definitive repair by aggressive blood pressure management has been suggested to be safe, and deliberate nonoperative management may be a reasonable alternative in selected patients with minimal aortic injuries detected with contrast-enhanced computed tomography. We report a case of acute aortic dissection due to blunt thoracic aortic injury resulting in splanchnic ischemia, for which we selected primarily nonoperative management, because the aortic tear was small but was complicated by multiple trauma. Although acute aortic dissection is an uncommon presentation of blunt injuries of the thoracic aorta and the poor prognosis has not been adequately emphasized, close observation, to evaluate the dissection and to determine whether splanchnic ischemia has developed, is recommended for patients for whom delayed definitive repair or nonoperative management has been selected.
authors.affiliation: Division of Emergency Medicine, Tohoku University Graduate School of Medicine, Tokyo, Japan. kkussie@emergency-medicine.med.tohoku.ac.jp
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kushimoto
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Shiraishi
authors.forename: Masato
authors.initials: M
authors.lastname: Miyauchi
authors.forename: Reo
authors.initials: R
authors.lastname: Fukuda
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Masuno
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yokota
mesh_terms: D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging; D001014:Aortic Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging; D017809:Fatal Outcome; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D014781:Viscera / Q000098:blood supply* / Q000000981:diagnostic imaging; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000000981:diagnostic imaging