Traumatic Tear of the Descending Aorta due to the fractured edge of the 7th rib; a case report

A 72-year-old male suffered a traumatic tear of the descending aorta and multiple rib fractures in a railway accident. The chest X-ray film revealed fractures of the left 5th to 11th ribs and hemo-pneumothorax, but no mediastinal hematoma suggesting aortic rupture. We operated 25 hours after the trauma because of shock state due to massive bleeding in the pleural cavity. During surgery a tear of the descending aorta was observed at the level of the 7th thoracic vertebral body. The fractured edge of the left 7th rib protruded into the pleural cavity. This seemed to be the cause of the aortic tear. Our case is the first clinical report of a thoracic aortic tear caused by such a mechanism. Multiple rib fractures near the vertebrae can cause aortic damage.