[Delayed surgical treatment of traumatic injury of the thoracic aorta]

A 55-year-old male, who had fallen down from a tree, was brought into the emergency room. The initial roentogenogram of the chest showed widening of the mediastinum, but CT study did not give the blood leaking out of the aorta. Thus the patient was managed in ICU. An aortography showed an aneurysmal dilatation of the descending aorta on ninth day after the injury, but we interpreted it may not proceed to the free rupture. Therefore we postponed the operation of the aortic injury until 41 days after the trauma. Immediate repair may be thought to be the first choice for acute traumatic injury of the thoracic aorta, but delayed surgery can be achieved safely on selective patients.