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Traumatic type B aortic dissection

P Goverde1, P Van Schil, F Delrue

  • 1Department of Surgery, University Hospital of Antwerp, Belgium.

Acta Chirurgica Belgica
|September 1, 1996
PubMed
Summary
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A rare case of type B aortic dissection resulted from blunt chest trauma. This condition, though uncommon, was successfully managed conservatively, with long-term monitoring revealing stable aortic dilation.

Area of Science:

  • Cardiology
  • Trauma Surgery
  • Diagnostic Imaging

Background:

  • Blunt thoracic trauma can cause aortic injuries, most commonly aortic rupture at the isthmus.
  • Type B aortic dissection, an intimal tear distal to the left subclavian artery, is a rare consequence of blunt chest trauma.

Observation:

  • A 37-year-old male presented with thoracic pain post-deceleration trauma, exhibiting a cerebral contusion and wrist fracture.
  • Diagnostic imaging, including CT and TEE, confirmed a type B aortic dissection without signs of rupture or distal ischemia.
  • Conservative management was initiated, complicated by paralytic ileus and persistent abdominal complaints.

Findings:

  • Follow-up CT at 3 years showed slight aortic dilation but no post-dissection aneurysm formation.
  • Angiography confirmed normal mesenteric vessel patency, ruling out vascular compromise as a cause of abdominal symptoms.

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Implications:

  • This case highlights that type B aortic dissection can occur after blunt thoracic trauma, albeit rarely.
  • Conservative management principles for type B aortic dissection are applicable even in traumatic cases.
  • Long-term surveillance is crucial for monitoring aortic changes after traumatic aortic injury.