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A lucky man who survived traumatic aortic rupture.

The patient was a 30-year-old man who was brought to hospital after his car flipped over while he was driving without fastened seatbelt. Both legs were fractured. A few days after admission to the orthopaedic ward, the patient developed sudden onset of dyspnoea, chest pain and persistent blood pressure elevation (220/120 mmHg). Because of high suspicion of aortic dissection or rupture, the patient was sent for a spiral chest computed tomography scan with intravenous contrast injection, which revealed a tear in the distal part of the aortic arch, contrast extravasation around the aorta extending a few centimetres into the descending aorta, bilateral hemothorax (especially on the left side) and alveolar infiltration (Fig. 1a). After control of blood pressure with nitroprusside and propranolol, in order to confirm the diagnosis and to achieve a better evaluation, transoesophageal echocardiography was performed, which was diagnostic for aortic rupture (Fig. 1b). The patient was brought to the operating room in an emergency and an aortic transection was identified proximal to the isthmus for a length of 4 cm (Fig. 1c). The damaged segment of the aorta was replaced with a Dacron graft. Postoperative recovery was uneventful.