HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rizoli, S. B. Articles by Maggisano, R. Search for Related Content PubMed PubMed Citation Articles by Rizoli, S. B. Articles by Maggisano, R.

Ann Thorac Surg 1994;58:1404-1408
© 1994 The Society of Thoracic Surgeons

---

Articles

Blunt diaphragmatic and thoracic aortic rupture: An emerging injury complex

Department of Surgery and the Trauma Program, Sunnybrook Health Science Centre, University of Toronto, Toronto, Ontario, Canada

Accepted for publication April 7, 1994.

^_* Address reprint requests to Dr Boulanger, Sunnybrook Health Science Centre, 2075 Bayview Ave, Room H-170, North York, Ont, Canada M4N 3M5.

Although both blunt diaphragmatic rupture (BDR) and thoracic aortic rupture (TAR) have been extensively discussed, the association of both injuries has been infrequently mentioned. The purpose of this study was to examine the current prevalence and clinical characteris tics of combined BDR and TAR at an adult regional trauma unit. Among 3,886 trauma victims, 69 (1.8%) had a BDR and 44 (1.1%), a TAR. Seven patients (10% of all patients with a BDR) had both injuries. All 7 were victims of motor vehicle crashes and had a mean Injury Severity Score of 35. All TARs were just distal to the origin of the left subclavian artery. Five patients under went repair of both injuries and survived, 1 patient had only the BDR repaired and survived, and 1 died during emergency thoracotomy, for a survival rate of 86%. Five patients had laparotomy and repair of the BDR in the presence of an unrepaired TAR. The TARs were repaired by the clamp-and-sew technique, three of them with primary repair and two with interposition tube grafts. Concomitant BDR and TAR appears to be an emerging injury complex with both diagnostic and therapeutic challenges. The presence of BDR demands a rigorous search for associated TAR.

This article has been cited by other articles:

				S. D. Steenburg, J. G. Ravenel, J. S. Ikonomidis, C. Schonholz, and S. Reeves Acute Traumatic Aortic Injury: Imaging Evaluation and Management Radiology, September 1, 2008; 248(3): 748 - 762. [Abstract] [Full Text] [PDF]

				T. S. Chughtai, P. Sharkey, F. Brenneman, and S. Rizoli Blunt Diaphragmatic Rupture Mandates a Search for Blunt Aortic Injury: An Update Ann. Thorac. Surg., March 1, 2007; 83(3): 1234 - 1235. [Full Text] [PDF]

				S. Rubin, O. N. Pages, A. Poncet, and B. Baehrel Endovascular Treatment of an Acute Subdiaphragmatic Aortic Rupture Ann. Thorac. Surg., December 1, 2006; 82(6): 2276 - 2278. [Abstract] [Full Text] [PDF]

				C. P. Cantwell The Dependent Viscera Sign Radiology, February 1, 2006; 238(2): 752 - 753. [Full Text] [PDF]

				C. J. Zeebregts, J. M. Klaase, and R. H. Geelkerken Endovascular Treatment of Traumatic Thoracic Aortic Rupture Combined with Diaphragmatic Rupture: A Case Report Vascular and Endovascular Surgery, May 1, 2003; 37(3): 219 - 223. [Abstract] [PDF]

				N. R. Tai and K. D Boffard Thoracic trauma: principles of early management Trauma, April 1, 2003; 5(2): 123 - 136. [Abstract] [PDF]

				M. J. Williams Blunt and Penetrating Trauma to the Thoracic Aorta Seminars in Cardiothoracic and Vascular Anesthesia, June 1, 2002; 6(2): 77 - 81. [Abstract] [PDF]

				D. Bergin, R. Ennis, C. Keogh, H. M. Fenlon, and J. G. Murray The "Dependent Viscera" Sign in CT Diagnosis of Blunt Traumatic Diaphragmatic Rupture Am. J. Roentgenol., November 1, 2001; 177(5): 1137 - 1140. [Abstract] [Full Text] [PDF]