A Patient with Multiple Trauma whose Life was Saved by Damage Control Surgery and Stent Grafting

Abstract

Thoracic aortic injury due to a blunt trauma is a potentially fatal condition and we often have difficulties in saving lives of the patients. It is associated with multiple trauma at the same time in many cases, where therapeutic strategies would be important for the treatment of multiple traumatic lesions.

A 71-year-old man received a CT scanning for a blunt trauma by a fall and was diagnosed as having a pseudotumor due to thoracic aortic injury, bowel perforation, and hepatic injury. Under laparotomy, we performed a repair of the perforated intestine, followed by damage control surgery with gauze packing to control bleeding from the injured site of the liver. Thereafter, when hemostasis was confirmed, the injured aorta was treated by thoracic aortic stent grafting. On the 55^th postoperative day, the patient was transferred to another hospital for the purpose of rehabilitation. In this case, we treated the intraabdominal injury preferentially because the injury had dominated his general condition, and then the injured aorta could be treated less-invasively through a two-staged approach.

In treating multiple trauma extending from the chest to the abdomen, it is important accurately to grasp the severity of each injury. The use of a stent is beneficial for traumatic aortic injuries and we should use it for further extended indications.