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Traumatic aortic rupture: delayed presentation with a normal chest radiograph.

D L Savitt1

  • 1Section of Emergency Medicine, Brown University, Providence, RI, USA.

The American Journal of Emergency Medicine
|May 25, 1999
PubMed
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Traumatic aortic rupture, a serious blunt trauma complication, can present subtly. This case highlights delayed diagnosis in an ambulatory patient despite a normal chest X-ray, emphasizing the need for vigilance.

Area of Science:

  • Cardiovascular Surgery
  • Trauma Surgery
  • Diagnostic Imaging

Background:

  • Traumatic aortic injury is a life-threatening consequence of blunt force trauma.
  • Patients often present with multiple injuries and varied clinical signs.
  • Early diagnosis is critical to prevent severe morbidity and mortality.

Observation:

  • Diagnosis of traumatic aortic injury is typically suggested by chest X-ray abnormalities.
  • This case involves an ambulatory patient with a delayed presentation of traumatic aortic rupture.
  • The presenting chest radiograph in this patient was notably normal.

Findings:

  • Delayed diagnosis of traumatic aortic rupture can occur even with normal initial imaging.
  • Ambulatory patients may present with subtle or atypical symptoms of aortic injury.

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  • The absence of radiographic findings does not exclude the possibility of aortic injury.

    • Implications:

    • Clinicians must maintain a high index of suspicion for traumatic aortic injury, regardless of initial imaging results.
    • Further diagnostic modalities may be necessary in cases of suspected aortic injury with normal chest radiographs.
    • Prompt recognition and management are crucial for improving outcomes in patients with traumatic aortic injuries.