[Aortic dissection associated with traumatic pericardial rupture]

We report a case of a 76-year-old man with traumatic aortic dissection complicated with cardiac herniation due to traumatic pericardial rupture. He was involved in an automobile crush and was transferred to our hospital. His vital signs were stable except for atrial fibrillation. Enhanced computed tomography (CT) showed aortic dissection on the descending aorta, multiple left rib fractures, substernal hematoma and shift of the heart toward the left chest cavity. We performed emergency operation. Through left thoracotomy, pericardial rupture was observed. Dacron graft replacement of the descending aorta and pericardial patch plasty were performed. He was discharged on the 24th postoperative day. Careful attention should be paid to aortic injury and pericardial rupture in the patient with severe blunt chest trauma.