[A case report of traumatic transection of the aortic arch]

A 16-year-old male, who sustained a blunt chest trauma in a traffic accident, was brought into the emergency room in an unconscious state, with an initial systolic blood pressure of 80 mmHg. He was found to have multiple fractures and a flail chest. The initial roentgenogram of the chest showed widening of the mediastinum. An emergency aortogram demonstrated intimal flap and aneurysmal dilatation of the aortic arch. Because of a coexisting severe contusion of the lung, operation was postponed until 15 days after admission. He was successfully treated by direct repair under profound hypothermia and circulatory arrest, which was induced by surface cooling in combination with ECC. Postoperatively he did well and 23 days after the operation, surgical repair of femoral and humeral fractures was performed by orthopedists.