Blue toe syndrome--a warning sign of unsuspected vascular injury

A case report is presented of a young patient involved in a motor vehicle accident, who initially demonstrated no physical or radiologic evidence of thoracic injury. Six weeks later the patient was noted to have two blue toes. Arteriography done at that time demonstrated a previously unsuspected false aneurysm of the descending thoracic aorta. An embolic event in a patient with a history of major trauma should be considered a strong indication for arteriographic evaluation of the proximal arterial system.