Zehnder, Max A.
June 1956
Angiology;Jun1956, Vol. 7 Issue 3, p252
Academic Journal
A case report in presented of a 21-year-old healthy male who sustained an incomplete traumatic aortic rupture at the posterior convexity of the aortic arch distal to the origin of the left subclavian artery (site of predilection) in a car collision accident. The undiagnosed lesion led to a lethal perforation through the initially intact adventitia into the left pleural space after a delay of 4 days. Death intervened on the fifth post-traumatic day. Etiologic-mechanical considerations are offered as to the commonest locations of aortic ruptures and their corresponding clinical features. All the clinical symptoms appear too vague and often are masked by concomitant injuries, therefore often remaining unrecognized. A flexion mechanism of the aorti arch might be the common denominator for traumatic ruptures at the anterior and posterior convexities of the aortic arch. Ruptures occur, in the author's opinion, from a tensile stress acting on the overstretched convexity over the incompressible intravascular fluid content. Chest compression, in addition to the deceleration thrust, is mainly responsible for the traumatic mechanism in the most common form of speed accidents in collisions of the road. Surgical intervention has as yet never been successfully performed. It is believed that surgical success is possible in cases of early and delayed ruptures and that this remains a diagnostic and surgical challenge.


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