Traumatic rupture of the thoracic aorta: diagnosis on fibreoptic bronchoscopy

The diagnosis of thoracic aortic rupture can be difficult, especially in the presence of other life-threatening injuries. We present a case in which the presence of major intraabdominal trauma shifted clinical attention away from the mediastinum. During bronchoscopy, which was performed to investigate high intraoperative airway pressures, unexpected tracheal and carinal compression were discovered. Thoracic aortography revealed aortic rupture distal to the left subclavian artery. Successful repair was subsequently achieved.