Abstract
A 71-year-old man suffered from a blunt thoracic aortic injury (BTAI) and bowel injury caused by a traffic accident. He did not exhibit any symptom, except for a severe abdominal pain. A computed tomography scan showed a pseudoaneurysm at the distal arch and a large amount of free air in the abdomen, which suggested peritonitis caused by bowel. Hence, an emergency abdominal operation was necessary. To avoid performing an emergency operation for the BTAI during the severe infection caused by peritonitis, we decided to perform a simultaneous operation for BTAI and bowel injury. First, after estimated a partial cardiopulmonary bypass through the femoral artery and femoral vein, we performed grafting of a pseudoaneurysm that was present around the distal arch through the left thoracotomy. The patients’ position was then changed, and the bowel injury site was repaired. After the operation, he was treated for various complications and needed a long rehabilitation period, but he was discharged from our hospital without any complication. It is difficult to determine the timing of the operation for BTAI in patients with multiple organ injuries. When bowel injury is present along with a BTAI, patients may develop severe infection, and we may not able to treat the BTAI. Therefore, some cases may require a simultaneous operation for BTAI and bowel injury.
