Background: Open aortic cross-clamping via a resuscitative left thoracotomy is effective in maintaining
adequate blood pressure in patients with abdominal bleeding until achieving hemostasis. However, the
procedure to encircle the descending aorta to secure cross-clamping is technically demanding for general
surgeons, especially in emergency situations.
Case Presentation: We report a case of rupture of the anterior superior pancreaticoduodenal artery
aneurysm associated with median arcuate ligament syndrome, which required surgical hemostasis. Because
of severe hypotension after laparotomy, open aortic cross-clamping with a left thoracotomy was performed
by general surgeons. However, the aortic clamps repeatedly slipped off because the clamping was conducted
without encircling the aorta. Then, we attempted finger clamping of the descending aorta, and the blood
pressure was quite effectively stabilized.
Conclusion: Descending aorta finger clamping via a resuscitative left thoracotomy is easy and feasible and
might be an effective procedure to maintain adequate blood pressure for general surgeons.