Endovascular repair of traumatic thoracic aortic pseudoaneurysm combined with simultaneous distal pancreatectomy due to the pancreas body rupture — case report and review of literatur

Abstract

Blunt traumatic thoracic aortic injury, which is usually accompanied by multiple organ injuries involving the head, abdomen or pelvis, is considered a dangerous, potentially life-threatening condition that requires rapid diagnosis and immediate surgical treatment. The most common location of traumatic aortic injuries is the aortic isthmus, which often results from the sudden deceleration during a road traffic accident. Traumatic injuries to the thoracic aortic wall are currently classified as four types: type I are injuries limited to the intima; type II is an intramural haematoma; type III means a pseudoaneurysm; and type IV is an aortic rupture. Conservative management, which involves strict blood pressure control and serial imaging, is recommended only in cases of intimal injuries, while type II to IV injuries should be managed operatively. It is currently believed that the introduction of endovascular techniques for the treatment of traumatic thoracic aortic injuries has become a valuable alternative for open surgery, as it has reduced mortality and the risk of early and late postoperative complications.In this article, we present long-term outcomes of treatment of a 19-year-old patient with a traumatic pseudoaneurysm of the descending aorta, which was successfully excluded from the systemic circulation through the implantation of a stent-graft combined with a simultaneous resection of the body and tail of the pancreas due to their rupture and splenectomy.