11/220. Traumatic total axial reversal of the thoracic vertebral body.Numerous vertebral fracture patterns have been reported in the literature. We present the case of a patient who sustained severe trauma to the back that resulted in a very unusual and not previously reported rotational injury consisting in complete 180 degrees rotation of the T6 vertebral body along a vertical axis, with only limited anteroposterior and lateral displacement. An unsuspected aortic tear resulted in severe evolution with fatal outcome following surgical attempt. The aetiology of such displacement is unknown. The possibility of late vascular complications should be kept in mind while treating thoracic spine fractures with rotational displacement.- - - - - - - - - - ranking = 1keywords = back (Clic here for more details about this article) |
12/220. Ruptured aneurysm of the sinus of valsalva in association with persistent left superior vena cava--a case report.A 58-year-old man presenting with chest pain and dyspnea was diagnosed by transesophageal echocardiography and cardiac catheterization to have the rare combination of ruptured aneurysm of noncoronary sinus of valsalva into the right ventricle in association with persistent left superior vena cava. These defects were confirmed at cardiac surgery. This case shows the importance of complementary use of invasive and noninvasive methods together in the diagnosis of rare combinations of lesions.- - - - - - - - - - ranking = 2.3747359697815keywords = chest, pain (Clic here for more details about this article) |
13/220. Blunt thoracic aortic injuries: initial evaluation and management.In at least one large study, the average time from arrival at the emergency department to arrival in the operating room was nearly 6 hours. That 30% of survivors will die in the same amount of time underscores the need for rapid diagnosis and treatment. In blunt thoracic aortic injury, beta-blockers have been shown to reduce the incidence of rupture, and their use is rarely contraindicated. A working knowledge of the mechanisms of injury likely to produce this lesion, commonly associated injuries, clinically relevant and easily recognizable chest film findings, and appropriate use of beta-blockade can have a significant impact on mortality. Any physician responsible for evaluation of trauma patients should be familiar with this information.- - - - - - - - - - ranking = 1.3595105225905keywords = chest (Clic here for more details about this article) |
14/220. Immediate endovascular repair for descending thoracic aortic transection secondary to blunt trauma.PURPOSE: To report the immediate endovascular treatment of a thoracic aortic tear secondary to blunt trauma. methods AND RESULTS: A 39-year-old man was injured in a motor vehicle collision. In addition to significant trauma to the head, chest, and abdomen, there were signs of a deceleration injury to the thoracic aorta. After urgent celiotomy to repair a lacerated spleen, the thoracic aortic transection was treated intraluminally using an endograft made of Gianturco Z-stents covered with polytetrafluoroethylene. The patient recovered from his injuries, and the thoracic endograft shows no evidence of endoleak 7 months after treatment. CONCLUSIONS: Endoluminal techniques can be used successfully in the immediate repair of thoracic aortic injuries.- - - - - - - - - - ranking = 1.3595105225905keywords = chest (Clic here for more details about this article) |
15/220. Localized dissection and delayed rupture of the abdominal aorta after extracorporeal shock wave lithotripsy.Extracorporeal shock wave lithotripsy (ESWL) represents the preferred treatment for most upper ureteric and renal calculi. Complication rates associated with ESWL are low, justifying the enthusiasm and acceptance of this treatment modality. As the technique has become more widely available, some deleterious effects on the kidneys and the surrounding tissues are increasingly recognized. We report on the rupture of a severely calcified abdominal aorta in a 65-year-old man who underwent 3 months of ESWL treatment earlier for renal calculi. The patient was seen with an acute recrudescence of a long-standing abdominal and left flank pain, which began immediately after the last of the three sessions of ESWL and was associated with an episode of hypotension that occurred an hour before admission. Patient history and chronologic course of events strongly suggest the role of ESWL in the genesis of abdominal aorta rupture.- - - - - - - - - - ranking = 1.0483549685478keywords = pain, upper (Clic here for more details about this article) |
16/220. aortic rupture and concomitant transection of the left bronchus after blunt chest trauma.We report a patient with traumatic aortic rupture and preoperatively unrecognized complete disruption of the bronchus for the left lower lobe. Preoperative state was complicated by inadequate oxygenation due to total atelectasis of the unventilated collapsed left lower lobe with consequent significant shunting of the unoxygenated blood. The patient had no massive pneumothorax because the intact peribronchial tissue and pleura covered the injured place, preventing important air leakage. The suspicion of possible concomitant tracheobronchial injury and early diagnostic bronchoscopy are important in patients with aortic rupture after blunt chest trauma.- - - - - - - - - - ranking = 6.7975526129525keywords = chest (Clic here for more details about this article) |
17/220. Primary aortoesophageal fistula: presenting as massive upper gastrointestinal hemorrhage.Primary aortoesophageal fistula is a rare cause of upper gastrointestinal bleeding. A six-year-old boy presented with massive upper gastrointestinal hemorrhage. endoscopy revealed a submucosal bulge in the esophagus with an ulcer and clot at the top. Lateral skiagram of the chest showed a posterior mediastinal mass. CT scan of the chest revealed a ruptured aortic aneurysm into the oesophagus, confirmed the diagnosis. The patient succumbed to the illness before he could be subjected to definitive treatment.- - - - - - - - - - ranking = 2.917798173322keywords = chest, upper (Clic here for more details about this article) |
18/220. Aortic dissection with fistula to right atrium after heart transplantation: diagnosis by transthoracic and transesophageal echocardiography.Aortic dissection with rupture into the right atrium is an extremely rare and rapidly fatal condition that may occur after cardiac surgery. We report the case of a 59-year-old woman with a 6-year history of heart transplantation who presented with subacute illness characterized by chest pain and severe cardiac decompensation accompanied by a continuous murmur in the precordium. The diagnosis of aortic dissection complicated by right atrial fistula was made by the combination of transthoracic and transesophageal echocardiographic examination.- - - - - - - - - - ranking = 2.3747359697815keywords = chest, pain (Clic here for more details about this article) |
19/220. Surgical management of traumatic thoracic aortic rupture from falling.A 40-year-male was admitted to our hospital after falling from a four-story height. Thoracic aortic rupture was suspected based on chest roentgenography and helical computed tomography. The patient was in the operating room within 6 hours after admission to the hospital. A median sternotomy with a left thoracotomy in the fifth intercostal space was done after left femoral arterial cannulation. Profound hypothermic circulation arrest with retrograde cerebral perfusion was applied. The site of aortic rupture was the descending aorta, just distal to the origin of the left subclavian artery. There were two areas of rupture within 2 cm of each other. The ruptured aorta was grafted with a 20-mm woven double-velour Hemashield graft. The total circulatory arrest time was 80 minutes and the cardiopulmonary bypass time was 290 minutes. The postoperative course was complicated by prolonged mechanical ventilation support due to pulmonary contusion. The patient was discharged 30 days after surgery without neurologic deficit.- - - - - - - - - - ranking = 1.3595105225905keywords = chest (Clic here for more details about this article) |
20/220. Fatal traumatic rupture of an aortic aneurysm of the sinus of valsalva: an autopsy case.This report describes an autopsy case of a rare type of aortic sinus of valsalva aneurysm, which caused fatal rupture from a blunt chest impact. A 51-year-old male was hit in the chest with a fist, lost consciousness after about 15min and died after approximately 7h. The postmortem examination revealed a large saccular aneurysm of the right coronary sinus bulging on the right atrium, which had a full laceration causing pericardial hematoma (cardiac tamponade). A related chest wall injury was observed in the right outer mammary region. A rare type of bulging onto the right atrium and subsequent sclerosis of the right coronary artery appeared to have greatly contributed to the fatal rupture.- - - - - - - - - - ranking = 4.0785315677715keywords = chest (Clic here for more details about this article) |
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