A Gardening Session Turns Into a Life Threatening Aortic Transection

Area of Science:

• Trauma Surgery
• Vascular Surgery
• Surgical Case Report

Background:

• Penetrating injuries to the sub-diaphragmatic aorta are rare but carry high mortality.
• Most aortic trauma results from ballistic or sharp force injuries.
• This report details a unique case of aortic transection from a fall onto a utility knife.

Observation:

• An 82-year-old female presented after a fall onto an 18 cm utility knife.
• CT angiography revealed infrarenal abdominal aortic transection, gastric, duodenal, and vertebral injuries.
• The patient was hemodynamically stable on admission with no neurological deficits.

Findings:

• Urgent midline laparotomy was performed for abdominal exploration.
• Successful aortic repair was achieved using a 14 mm polyester graft.
• Associated visceral injuries to the stomach and duodenum were repaired; the postoperative course was uneventful.

Implications:

• Penetrating abdominal trauma involving aortic transection and visceral injuries is a high-risk scenario.
• Early recognition through a low threshold for imaging is crucial.
• Multidisciplinary management involving vascular and visceral surgeons is essential for successful outcomes.