Traumatic abdominal aortic injury treated by endovascular stent placement

Traumatic injury of the abdominal aorta is rare and potentially lethal. The authors present the case of a restrained passenger who was involved in a high-speed, head-on motor vehicle accident. On arrival in the emergency department, the patient complained of abdominal pain, was tachycardic and had a large ecchymoses on his right flank and lower abdominal wall. Computed tomography (CT) angiography (CTA) of the abdomen revealed a degloving injury to the abdominal wall, small bowel injury, and a distal abdominal aortic injury with a small amount of retroperitoneal hemorrhage. The patient underwent surgical repair of bowel injuries and the anterior abdominal wall. Because of risk of peritoneal soiling, open repair of the aorta was not attempted. The interventional radiology and vascular surgery services performed an endovascular repair of the aortic injury using a bifurcated endograft.