Abstract
A 59-year-old woman with blunt multiple trauma was transferred to our emergency unit. A computed tomography revealed both an intimal flap of the descending aorta and cerebral bleeding. Immediate aortic surgery was considered, however full heparinized cardiopulmonary bypass (CPB) was not suitable because of acute brain hemorrhage. We performed surgery 55 days after the trauma. On operation 75% of the intima at the descending aorta was disrupted circumferentially. The descending aorta was replaced by a prosthetic graft under CPB. The postoperative course was uneventful and the patient has been well for 30 months after surgery. In treating aortic dissection associated with blunt trauma, emergency surgery should be performed immediately when possible, however there can be some limitations because of other acute organ injury. Accurate information concerning other injured organs, obtained by careful examination, may help an appropriate decision to be reached.
