Gunshot wounds of the suprarenal abdominal aorta

A review of recent series of penetrating aortic injuries is presented. The highest mortality rates were found with injuries of the suprarenal abdominal aorta. Five patients with this injury, four of whom survived, are presented. Factors preventing rapid exsanguination in some patients are explained. Surgical management, including the controversy of arterial debridement, is discussed. The possibility of missing an aortic perforation at operation with five examples from the literature is pointed out.