Ann Surg Case Rep | Volume 1, Issue 2 | Case Report | Open Access

Acute Thoracic Aortic Occlusion with Diffuse Mesenteric Ischemia and Death due to Vertebral Fracture Dislocation after Motorcycle Crash: Case Report and Review of the Literature

Jamal Fitts¹, Carolyn Moore¹, Thomas Moore Jr², Allan Pickens², L Ray Matthew¹, Jonathan Nguyen¹, Kahdi Udobi¹, K Aviva Bashan-Gilzenrat¹, Assad Taha¹, Ed W Childs¹ and Omar K Danner^1*

¹Department of Surgery, Morehouse School of Medicine, USA
²Emory University School of Medicine, USA

^*Correspondance to: Omar K Danner 

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Abstract

Acute traumatic thoracic aortic occlusion, related to thoracic vertebral body fractures, is an emergent, but rare vascular event. These patients have to be identified and managed in an efficient manner to achieve the best outcomes. We present the case of a 16 year old male who was involved in a motorcycle versus truck crash. He was transferred from an outside hospital. He subsequently developed global mesenteric ischemia with complete bowel necrosis secondary to traumatic thoracic aortic occlusion following this high energy trauma. On-table angiography via both femoral and brachial cut down approaches showed truncation of contrast in the aorta at the level of the fracture. The decision was made to perform an axillo-bifemoral bypass anastomosis to restore flow to the mesentery and lower extremities due to inability to pass a catheter and stent open the lesion. However, the bowel was re-inspected and noted to be dark and dusky, consistent with mesenteric infarction. Spy angiography was used to confirm there was no arterial supply to the viscera. Thus, the decision was made to abort surgical revascularization as the injury was deemed to be catastrophic and restoration of perfusion was deemed futile. In conclusion, the case highlights a rare clinical condition of traumatic thoracic aortic occlusion associated with acute mesenteric ischemia due to vertebral spondylolisthesis/fracture dislocation.

Citation:

Fitts J, Moore C, Moore T Jr, Pickens A, Matthew LR, Nguyen J, et al. Acute Thoracic Aortic Occlusion with Diffuse Mesenteric Ischemia and Death due to Vertebral Fracture Dislocation after Motorcycle Crash: Case Report and Review of the Literature. Ann Surg Case Rep. 2018; 1(2): 1007.