Traumatic Rupture of the Aortic Isthmus: Program of Selective ManagementRID="" ID="" This International Association for the Surgery of Traumaand Surgical Intensive Care (IATSIC) article was presented at the 37thWorld Congress of Surgery International Surgical Week (ISW97),Acapulco, Mexico, August 24n30, 1997.

摘要: Two hypotheses were investigated: (1) helical computed tomography (CT) of the chest on victims decelerating trauma can yield a diagnosis of, or "rule out," traumatic rupture aorta (TRA) without need for an aortogram; and (2) selective delay aortic repair be safely accomplished through medical management protocol. Screening CT examinations done 6169 blunt thoracic trauma; 47 found to have TRA; in 8, indirect but nondiagnostic findings not clarified by aortogram led surgical exploration. The sensitivity was higher than that aortograms, "normal" scan never associated with proved TRA. It is estimated use has resulted at least 40% 50% decrease addition yielding rapid, noninvasive valuable information about other injuries. Drugs (beta-blockers +/- vasodilators) stress wall used 93 patients when suspected continued as necessary evaluation, stabilization, until cross-clamped operation. Elective, delayed operation between 2 days 25 months 15 who deemed excessive risks emergency repair; there deaths (13. 3%). Eleven had repair. No patient maintained this protocol, whether repaired emergently, electively, all, developed free periaortic hematoma death from