Early Repair of Traumatic Rupture of the Thoracic Aorta
| Autor: | L. L. Bromley, R. E. Robinson, J. T. Hobbs |
|---|---|
| Rok vydání: | 1965 |
| Předmět: |
Adolescent
Thoracic Injuries Parietal Pleura Aortic Rupture Aorta Thoracic medicine.artery medicine.ligament Humans Medicine Thoracic aorta Aortic rupture Aorta General Environmental Science Hemothorax Ligamentum arteriosum business.industry Accidents Traffic General Engineering Papers and Originals General Medicine Anatomy Pleural cavity medicine.disease medicine.anatomical_structure Accidents Descending aorta cardiovascular system General Earth and Planetary Sciences Radiography Thoracic business Vascular Surgical Procedures |
| Zdroj: | BMJ. 2:17-19 |
| ISSN: | 1468-5833 0959-8138 |
| DOI: | 10.1136/bmj.2.5452.17 |
| Popis: | Rupture of the thoracic aorta due to the trauma of abrupt deceleration is becoming more common in this age of high-speed travel and collision. The clinical picture of the torn aorta may not be recognized during life as it is not generally realized that it can occur without evidence of external injury to the chest. The injury is closed, rupture usually occurring just distal to the ligamentum arteriosum, this site being the junction of the descending aorta, which is relatively fixed by the paired intercostal vessels, and the arch of the aorta, which is only suspended by the head vessels and which moves forward on impact with a severe shearing strain. One of three things can happen: the aorta may be completely divided and the overlying parietal pleura torn, with immediate exsanguination into the mediastinum and left pleural cavity ; secondly, although rupture of the intima and media is complete, the adventitia may be incompletely disrupted, and this, together with the intact parietal pleura, temporarily contains the expanding aneurysm, which may, within minutes or hours, burst into the pleural cavity ; and, finally, the remaining adventitia and pleura can succeed in containing the aneurysm, so that a localized aneurysmal sac develops which slowly expands until it ruptures. In those patients surviving for a short time it is not possible to know whether rupture is imminent, but evidence of continued internal haemorrhage, an expanding mediastinal shadow on jc-ray examination, and an increasing pleural effusion are signs that early rupture is probable, and surgical treatment should be immediately undertaken. |
| Databáze: | OpenAIRE |
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