Aortic transection secondary to rodeo injury

Aortic transection usually occurs in the course of automobile accidents. The authors present an unusual case of aortic transection in a 27-year-old male who was thrown from a bull during a rodeo competition. Surgical repair was successful. The mechanisms of sudden deceleration and blunt impact in the pathogenesis of aortic rupture are discussed. A high index of suspicion aids in the diagnosis of unusual or subtle cases. Plain chest films may suggest the diagnosis, but aortography is currently the gold standard for establishing the diagnosis. Surgical repair is mandatory, and the use of left atrial-to-femoral bypass may lower the incidence of complications such as paraplegia and renal failure. Newer issues in the diagnosis and management of aortic transection include the use of transesophageal echocardiography and the placement of endoluminal prostheses.