[Multi-organ ischemia due to traumatic lesion of the descending thoracic aorta--a case-report]

This is a case of severe ischemic and reperfusion multi-organ failure due to descending thoracic aortic rupture. A 25 year-old man received a hard blow on his chest in a traffic accident. Chest X-ray, CT scans and aortogram elucidated descending thoracic aortic rupture. Emergency operation was performed 18 hours after the injury. The aortic rupture, 4/5 of the aortic circumference with intact adventitia was seen. The descending aorta 22 distal to the left subclavian artery was repaired under cardio-pulmonary bypass with selective cerebral perfusion. Ischemia due to aortic occlusion with thrombus and reperfusion injury after reconstruction of the aorta connected with rhabdmyolysis and severe multi-organ failure. Intestinal necrosis required laparotomy on the 9th and 15th post operative day. The patient died on 15th postoperative day of multi-organ failure.