[Rupture of the thoracic aorta and multiple injuries]

Traumatic rupture of the thoracic aorta is an extremely severe injury, and is usually fatal. The injury is most often seen in forceful deceleration trauma. This complicates the priority of diagnosis and treatment in relation to other severe injuries in the same patient. During the period 1984-1991, nine patients underwent operation for this injury at the Department of Thoracic Surgery. Two patients succumbed, because of free rupture in the operating theatre. The others survived. Three of these were treated by directly suturing the rupture, and four by introducing a prosthesis. The prognosis in operated traumatic rupture of the thoracic aorta is good if the haematoma is contained. Relevant history of deceleration and suspicion of mediastinal widening should lead to arcography and prompt operation if the diagnosis is confirmed. Only significant intraabdominal or intracranial hemorrhage supersede aortic rupture in the initial priorities for treatment.