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        Unusual Presentation of a Penetrating Aortic Arch Injury

        Fikret Sami Vural,Atul Kumar Patel,Kashif Mustafa 대한흉부외과학회 2017 Journal of Chest Surgery (J Chest Surg) Vol.50 No.4

        A 27-year-old man was admitted with a penetrating injury at the mid-manubrium. Computed tomographic (CT) angiography s howed a f illing def ect in t he a ortic arch. This was e valuated a s a sign o f injury and the patient underwent an e mergency o peration. No a ctive bleeding o r clot w as f ound in t he m ediastinum d uring the operation. The laceration point was between the innominate and the left carotid artery posteriorly. The injury was approached using hypothermic circulatory arrest. Aortotomy and exploration showed a 2-cm-long full-thickness aortic injury with an overlying clot. A filling defect on angiography as a sign of a penetrating arch injury has never been reported previously, but was the main pathological finding on CT angiography in our case. The aorta is a high-pressure system and injuries to it should be treated aggressively.

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