[Rupture of thoracic aorta due to blunt trauma: a report of three cases]

Three cases of the thoracic aortic rupture due to blunt trauma were successfully treated. All of the cases were young male motorcyclists. The chest X-ray on admission showed either a widened mediastinum or an apical extrapleural cap sign. Ruptures were confirmed by an enhanced CT clearly showing the presence of a psuedoaneurysm and a hematoma around the isthmus of the aorta. One of them was operated upon urgently and others in whom heparin could not be used because of associated injuries were operated upon electively two and three months after the traffic accident, respectively. In two of them, aneurysms were removed and replaced with dacron grafts and in the remaining one, the aneurysm was resected and repaired directly under the femoro-femoral bypass. Post-operative courses were uneventful. They discharged and are doing well after the treatment for associated injuries. In view of the high early mortality of aortic rupture, an early diagnosis and treatment is important. But in the case who has stable hemodynamics and contraindication for heparinization, a delayed operation may be recommended.