A Case of Acute Type A Aortic Dissection with Liver Injury of Unknown Cause
- VernacularTitle:術中に外傷性肝損傷が発覚した急性A型大動脈解離の1症例
- Author:
Hirotaka YAMAUCHI
1
;
Takeki OHASHI
1
;
Soichiro KAGEYAMA
1
;
Akinori KOJIMA
1
;
Hideo MORITA
1
;
Takanori HISHIKAWA
1
;
Hirofumi SOGABE
1
Author Information
- Keywords: acute type A aortic dissection; liver injury; trauma
- From:Japanese Journal of Cardiovascular Surgery 2024;53(5):267-269
- CountryJapan
- Language:Japanese
- Abstract: AAAD (Acute type A aortic dissection) may cause trauma, due to a fall down with LOC (loss of consciousness), which can be missed when the disturbance of consciousness is prolonged. Intraoperative heparinization may result in persistent bleeding, and trauma due to a fall with LOC associated with acute aortic dissection should always be kept in mind. An 81-year-old woman underwent emergency surgery for ruptured AAAD with LOC. Preoperative hemodynamics were unstable and low blood pressure persistent even after release of the cardiac tamponade. The partial arch replacement with brachiocephalic artery reconstruction was performed. Before the chest was closed, a large amount of bloody ascites was noted in abdomen and multiple traumas of the liver were found, resulting in a diagnosis of traumatic liver injury due to a fall with LOC. The patient had liver cirrhosis and coagulation abnormality, and hemostasis was difficult to achieve. The operation was finished with gauze packing and placed ABTHERA® was placed for open abdominal wounds. The abdomen was closed in the second stages. The patient's postoperative course was good, and the patient was transferred for continued rehabilitation.
