[Early detection of traumatic aortic aneurysms using transesophageal Doppler echocardiography]

The early diagnosis of traumatic aortic dissections and aneurysms involving the thoracic aorta is of crucial importance for the outcome of patients suffering chest injuries. This subject is presented using two case reports; one illustrates the problems resulting from an overlooked traumatic aneurysm of the thoracic aorta and the second shows the possibilities of detecting such potentially lethal injuries early in patients with thoracic or multiple injuries, using the transesophageal Doppler echocardiography (TDE). The advantages and disadvantages of using TDE as compared to the more conventional methods such as the precordial Doppler echocardiography, computed tomography and angiography, are discussed. The particular advantage of this hardly invasive or burdening method is its immediate availability in the emergency room to assess patients with evident thorax trauma. In the intensive care unit TDE may be of value in screening polytraumatised patients who offered no primary evidence for chest injury upon arrival.