Traumatic rupture of the aorta in adolescence--description of two cases

Aortic disruption is a well documented cause of death in motor vehicle accidents and falls from heights. These injuries also affect children. About 10 % who survive despite aortic injury could potentially be saved provided the diagnosis is established and surgical intervention is undertaken early enough. We present here 2 cases of adolescents aged 17 years, treated in our hospitals with different results. In the first case, timely diagnosis of aortic pseudoaneurysm could not be made, which resulted in its rupture and the death of the patient. In the other patient an early diagnosis of aortic injury was established already in the Emergency Department. The patient was then transferred for further surgical treatment which proved successful. Diagnosis of traumatic aortic rupture is impossible at the accident site and can also be missed in hospital. The symptoms of aortic rupture are not characteristic. The knowledge of the mechanism of injury is extremely important. The diagnosis is established based on chest X-ray, computed tomography, and transoesophageal echocardiography. In cases of doubt, aortography remains decisive in the identification of an aortic injury.