Case study: An unusual and fatal injury: stab wound of a bovine aortic arch anomaly

Abstract

Penetrating trauma of the aortic arch is relatively uncommon, even at busy trauma centers. Such an injury is challenging, especially in a "crashing" patient in whom emergency surgery is undertaken. When this scenario is coupled with an aortic arch abnormality, it may be infinitely more difficult to deal with, and the injury may prove non-salvageable. Bovine aortic arch abnormality occurs in approximately 25% of patients in our setting, according to existing literature. Hence, penetrating injury of a bovine aortic arch would be extremely rare. We present a patient who sustained a stab wound to a bovine arch, which proved non-salvageable because proximal and distal vascular control could not be provided without rendering the brain anoxic. We provide an overview of the bovine arch abnormality and a brief review of the management of aortic arch injuries.