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Emergent endoluminal repair of delayed abdominal aortic rupture after blunt trauma
R Scharrer-Pamler1, J Görich, K H Orend
1Division of Thoracic and Vascular Surgery, University Hospital, University of Ulm, Germany.
Purpose:
To report the emergency repair of a traumatic abdominal aortic rupture using endoluminal techniques.
Methods And Results:
A 25-year-old female sustained multiple head, chest, and abdominal injuries in a motorcycle accident. Six days after emergency treatment (including splenectomy and repair of a superficial hepatic rupture and lacerations to the stomach, small bowel, and colon), she became hemodynamically unstable. A massive retroperitoneal hematoma had evolved from a distal aortic rupture. Owing to a hostile abdomen and possibility of bacterial contamination, a self-expanding stent-graft was inserted transfemorally to repair the aortic injury. The patient recovered uneventfully and continues in good health with a patent endograft repair 2 years after treatment.
Conclusions:
This experience would support the efficacy of endograft implantation for emergent repair of trauma aortic injuries; however, proper facilities, an experienced interventional team, and an assortment of endografts and stents must be available.