2017 Volume 31 Issue 4 Pages 457-460
A 42-year-old man was brought to our trauma center in hemorrhagic shock caused by a motorcycle accident. We diagnosed left diaphragm injury with evisceration into the thoracic cavity, unstable pelvic fracture, and right femur fracture. First, transcatheter arterial embolization and external fixation were performed for the pelvic fractures, and the diaphragm injury was repaired for respiratory stabilization. A computed-tomography scan revealed two thoracic aortic lesions. As we found no extravasation of contrast media, we continued careful observation. On hospital day 16, thoracic endovascular aortic repair (TEVAR) was performed for the isthmus injury. A follow-up computed tomography scan indicated enlargement of the arch injury. Therefore, total arch replacement was performed on hospital day 24. Both TEVAR and thoracotomy are necessary for the management of multiple lesions due to blunt thoracic aortic injury.
