Dissecting hematoma of the aorta secondary to blunt chest trauma

Two types of dissecting aortic hematoma occasionally follow blunt chest trauma. Localized subadventitial dissecting may occasionally accompany aortic laceration or transection. This subadventitial hematoma may itself rupture, or it may compress the true aortic lumen. In the presence of arteriosclerosis, classical (medial) dissecting hematoma may occur following blunt trauma. The trauma may be considerably less than that required to cause aortic rupture. Differentiation of the two forms may have practical significance. The treatment of aortic laceration is surgical repair, whether or not there is an associated subadventitial dissection. However, medial dissection following trauma is indistinguishable from spontaneous aortic dissection, and medical therapy may sometimes be the preferred method of treatment.