[Surgical management of a chronic post traumatic dissection of the abdominal aorta]

The clinical case of a 34 years old male is reported, who was referred to our clinic complaining of disabling claudication of the lower extremities. No risk factors for atherosclerotic disease could be identified. Six years previously he sustained a severe automobile crush injury, resulting in cranio-encephalic and abdominal trauma, and fractures of the left knee and both legs. Appropriate medical and surgical care were delivered and he recovered completely, with no restrictions. Six months before the observation, he started to complain of intermittent claudication of both legs. An angio-CT evaluation disclosed the diagnosis of a chronic dissection of the abdominal aorta of post traumatic etiology, causing significant restriction of blood flow to the lower extremities. The patient underwent surgical management consisting of the resection and prosthetic replacement of the abdominal aorta. The post operative course was uneventful and he became asymptomatic. A control angio-CT study revealed the graft working in excellent condition. The main features of this clinical entity are analyzed and discussed based on a clinical revision of the bibliography on the subject.