Atypical presentation of aortic dissection secondary to a gunshot wound

[Acute post-trauma dissection of the descending thoracic aorta]

BACKGROUND

Traumatic injury to the descending thoracic aorta other than the isthmus is rare, and little known. Acute post-trauma rupture may occur in a context of multiple or rarely unique localizations.

CASE REPORT

We report the case of a young man who was the victim of multiple injuries with an isolated rupture of the descending thoracic aorta. Early diagnosis and adapted endovascular treatment led to favorable outcome.

CONCLUSION

In 90% of cases, acute post-trauma rupture of the aorta in a single localization involve the isthmus. Rupture of the descending aorta is more exceptional but must not be missed. The pathophysiological mechanism and appropriate management are discussed in light of a review of the literature.

[Traumatic injuries of the descending thoracic aorta apart from the isthmus: diagnosis and therapeutic approach]

Lesions involving the descending thoracic aorta apart from isthmus are rare and less known by anesthetists. We report the clinical course of two severely injured patients who sustained a thoracic aortic rupture in whom favorable outcome was achieved with endovascular treatment. Mechanisms, diagnosis and therapeutics aspects of these rare lesions are discussed according to literature.

[Aortic thrombi associated with thoracic gunshot wound]

We report the case of a stroke due to a ballistic thoracic traumatism. The vascular injury, provoked by the passage of the bullet, associated to a procoagulating state led to the formation of a thrombus in the ascending aorta. The migration of this thrombus caused a stroke, finally reversible upon medical treatment only.