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Case Reports
. 2018 Apr;10(4):E309-E312.
doi: 10.21037/jtd.2018.04.51.

Successful phased approach to a patient with synchronous traumatic descending aortic pseudoaneurysm and bronchial rupture

Jiandong Mei  1 , Chenglin Guo  1 , Lunxu Liu  1 , Guowei Che  1 , Qiang Pu  1
Affiliations
Case Reports

Successful phased approach to a patient with synchronous traumatic descending aortic pseudoaneurysm and bronchial rupture

Jiandong Mei et al. J Thorac Dis. 2018 Apr.

Abstract

A 34-year-old woman was referred to our center because of collapsed left lung and left main bronchial stenosis 1 week after a vehicular accident. Bronchoscopic observation revealed stenosis in the left main and lobar bronchus. Computed tomography (CT) angiography found traumatic descending aortic pseudoaneurysm after admission. Phased intervention strategy was adopted. The aortic rupture was repaired with endovascular stent firstly, followed by sleeve reconstruction of the left main bronchus through posterolateral thoracotomy 11 days later. She recovered uneventfully and resulted in an excellent long-term outcome. The diagnosis and treatment of this case is discussed.

Keywords: Aortic pseudoaneurysm; blunt chest trauma; bronchial rupture.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Bronchoscopic observation and chest CT scan after admission. (A) Bronchoscope revealed complete occlusion of the left upper lobar orifice (arrowhead) and line-stenosis of lower lobe bronchus (arrow); (B) chest CT showed normal-shaped aorta (arrowhead) but suspicious dissection with contrast (arrow); (C,D) descending aortic pseudoaneurysm was confirmed with CTA (arrow). CTA, CT angiography.
Figure 2
Figure 2
Postoperative chest image and bronchoscopic view. (A) Chest film showed fully re-expansion of the lung on POD 7; (B,C) bronchoscope and chest CT showed the bronchus work well before discharging. POD, postoperative day.
See this image and copyright information in PMC

References

    1. Sadow SH, Murray CA, 3rd, Wilson RF, et al. Traumatic rupture of ascending aorta and left main bronchus. Ann Thorac Surg 1988;45:682-3. 10.1016/S0003-4975(10)64780-7 - DOI - PubMed
    1. Marzelle J, Nottin R, Dartevelle P, et al. Combined ascending aorta rupture and left main bronchus disruption from blunt chest trauma. Ann Thorac Surg 1989;47:769-71. 10.1016/0003-4975(89)90141-0 - DOI - PubMed
    1. Neschis DG, Scalea TM, Flinn WR, et al. Blunt aortic injury. N Engl J Med 2008;359:1708-16. 10.1056/NEJMra0706159 - DOI - PubMed
    1. Karmy-Jones R, Wood DE. Traumatic injury to the trachea and bronchus. Thorac Surg Clin 2007;17:35-46. 10.1016/j.thorsurg.2007.03.005 - DOI - PubMed
    1. Exadaktylos AK, Duwe J, Eckstein F, et al. The role of contrast-enhanced spiral CT imaging versus chest X-rays in surgical therapeutic concepts and thoracic aortic injury: a 29-year Swiss retrospective analysis of aortic surgery. Cardiovasc J S Afr 2005;16:162-5. - PubMed

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