POSTTRAUMATIC DISSECTION OF THE AORTIC IS THMUS WITH A FAVORABLE OUTCOME WITHOUT SURGERY - VALUE OF TRANSESOPHAGEAL ECHOCARDIOGRAPHY

We report a case of intimal rupture of aortic isthmus in a severe poly trauma patient diagnosed with transoesophageal echocardiography (TEE). TEE findings were as follows: localized intimal tear without increase d aortic diameter or pseudoaneurysm, absence of mediastinal haematoma or false lumen. CT scan and MRI confir med the diagnosis. Because of t he associated injuries, surgery was delayed. Conservative management w as successful and the patient was discharged without aortic surgery. A follow up TEE, 3 and 6 months later showed a thrombosis of the intima l tear without false aneurysm. This case underlines the value of TEE i n patients with thoracic trauma, for surgical or nonsurgical managemen t of aortic rupture and for the follow up of the patients.