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Mid-descending aortic traumatic aneurysms.

I Rabinsky1, G S Sidhu, R B Wagner

  • 1Department of Surgery, Prince Georges Hospital Center, Cheverly, Maryland.

The Annals of Thoracic Surgery
|July 1, 1990
PubMed
Summary
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Diagnosing traumatic rupture of the mid-descending aorta is challenging, often missed due to lack of mediastinal hematoma or inadequate imaging. Early suspicion and two-plane aortography are crucial for timely intervention.

Area of Science:

  • Cardiovascular Surgery
  • Trauma Surgery
  • Diagnostic Imaging

Background:

  • Traumatic rupture of the mid-descending aorta is a rare but life-threatening injury.
  • Clinical series often exclude this specific aortic injury, limiting available data.
  • Previous literature reports only 9 cases, highlighting its infrequent diagnosis.

Observation:

  • Diagnosis is frequently missed or delayed in patients with aortic tears.
  • Absence of a superior mediastinal hematoma can lead to delayed diagnosis in 4 cases.
  • Inadequate single-plane aortography contributed to delayed diagnosis in 2 cases.

Findings:

  • Severe hyperextension, often with thoracic vertebral injury, is the likely mechanism for descending aortic tears.
  • A high index of suspicion is essential for identifying these injuries.

Related Experiment Videos

  • Complete two-plane aortography is critical for accurate diagnosis.

    • Implications:

    • Overlooking mid-descending aortic tears can lead to catastrophic outcomes.
    • Enhanced diagnostic vigilance and improved imaging techniques are necessary.
    • This case series emphasizes the importance of considering aortic injury even without classic signs.