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[Traumatic double rupture of the isthmic aorta. Apropos of an unrecognised case successfully treated by two-stage surgery].

The authors report the case of a 33 year old patient, who underwent an emergency repair of a traumatic tear of the thoracic aorta, after a car accident. This operation was carried out with femoro-femoral cardiopulmonary bypass support. Associated lesions were traumatic tear of the left diaphragm repaired through left thoracotomy during repair of the aorta, rupture of the liver and multiple fractures of the left superior limb. Postoperative course was marked by liver hemorrhage and septicemia. Orthopedic treatment of the various fractures was performed. The course of thoracic lesions was uneventful. An aneurysm of the aortic isthmus was revealed during venous digital subtraction angiography routinely performed 60 days after surgery. The patient was reoperated with femoro-femoral bypass support. A second incomplete tear of the aorta, missed during the first operation was discovered 3 cm above the suture of the first one. This lesion was easily repaired and the post-operative course was uneventful. The value of systematic control angiography after aortic traumatic repair is emphasised.