Uncontrollable Bleeding Managed by Thoracic Gauze Packing in Blunt Traumatic Aortic Injury.

Abstract

Blunt traumatic aortic injury is a deadly phenomenon in traumatic injuries. Damage control is essential in the management of traumatic patients. We reported a 20-years-old man brought to the trauma center from a car turnover crash scene. Blunt traumatic aortic injury grade III was revealed by contrast-enhanced computed tomography requiring urgent intervention. After an uneventful open repair of the aorta with Dacron graft, diffuse blood oozing occurred from the mediastinum and left pleural cavity. We packed the thoracic bleeding sites and removed the packings after four days. The patient developed no signs of cardiopulmonary compromise until the removal of the packings. Later, the patient was discharged with no complications. Through the follow-ups, he had no complaint regarding the surgery. The patient has a normal chest x-ray one year later. Thoracic gauze packing is limitedly practiced due to concerns for cardiopulmonary compromises. To the best of our knowledge, this is the first time that this technique has been performed in the open repair of blunt traumatic thoracic aortic injury as damage control.