DELAYED SURGICAL THERAPY OF ACUTE TRAUMAT IC AORTIC-ANEURYSM

Immediate surgical treatment of traumatic aneurysms of the aorta is in our point of view in most cases problematic, also because of the comb ination with life threatening injuries of other organ systems. In our own patient-collection seven patients out of 44 with traumatic transse ction were immediately operated. Six patients died in tabula, three of them due to uncontrollable hemorrhage. An analysis of over 5,000 post mortem findings from the department of forensic medicine in Hamburg r evealed that injuries of the aorta lead in 98.3 % to death in the firs t two hours after the accident. This shows that only a small number of injured victims survive. The danger of a two stage rupture is judged differently. We did not observe this problem in the patients with aort ic lesion following blunt chest trauma and stable conditions who had f irst undergone treatment for other injuries and therefore operated in the interval period after two to ten weeks. With this strategy the let hality involving surgical management of aortic injuries in our unit de creased to 13 %.