Modern management of abdominal aortic injuries: What you need to know

Abdominal aortic injury is a rare but deadly traumatic insult that occurs in <0.1% of trauma patients but carries a mortality rate of 29% to 70%. Penetrating injuries usually present with shock and require rapid hemorrhage control through open abdominal exploration. Blunt injuries are increasingly being managed nonoperatively and with endovascular techniques. Both mechanisms are commonly associated with other severe intra- and extra-abdominal injuries. The trauma surgeon must be prepared to promptly evaluate for intra-abdominal hemorrhage and choose the appropriate clinical pathway to diagnose and manage abdominal aortic injury. (J Trauma Acute Care Surg. 2026;101: 199-207. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved.).