Visceral ischemia caused by acute aortic dissection following blunt aortic injury: Report of a case

The diagnosis and management of blunt thoracic aortic injuries have seen significant changes over the last decade. The purposeful delay of definitive repair by aggressive blood pressure management has been suggested to be safe, and deliberate nonoperative management may be a reasonable alternative in selected patients with minimal aortic injuries detected with contrast-enhanced computed tomography. We report a case of acute aortic dissection due to blunt thoracic aortic injury resulting in splanchnic ischemia, for which we selected primarily nonoperative management, because the aortic tear was small but was complicated by multiple trauma. Although acute aortic dissection is an uncommon presentation of blunt injuries of the thoracic aorta and the poor prognosis has not been adequately emphasized, close observation, to evaluate the dissection and to determine whether splanchnic ischemia has developed, is recommended for patients for whom delayed definitive repair or nonoperative management has been selected.