| Objective: Blunt aortic injury(BAI) is a rare and lethal disease, it is often caused by traffic accidents and fall from height. Most hospitals and surgeons receive little exposure during work, it is easily overlooked when a trauma patient admitted to hospital. The purpose of this paper is to report 4 cases treated in this hospital during 20 years and review relevant literatures, share our experience with colleagues.Method: Search for all medical records of thoracic trauma and aorta diseases between 1990 and 2010, 4 cases which diagnosed and operated in our hospital was included in this retrospective study. The clinical presentation, radiology finding and treatment were analyzed retrospectively.Outcome: The diagnosis and treatment was delay to different extends in all cases. Normal chest film was found in 3 cases, only 1case showed abnormal aortic node and left bronchus deviation. All 4 cases was diagnosed by enhanced CT or MRI. 3 cases show associated injuries, which were all treated before BAI. 1 case received open surgery, 3 cases received endovascular repair(EVR). The surgery case died of unstoppable bleeding during surgery, 2 cases show complication of endoleak after EVR. 1 case died of respiratory failure after 13 months, and the rest was lost during follow up. Conclusion: BAI is a rare disease. Considering injury history and associated trauma and taking advantage of enhanced helical CT would be benefit to early diagnosis of BAI. Open surgery is associated with high mortality, EVR show a more favorable early outcome, but still lack of sufficient data to prove its long term durability.
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