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Aortic transection

P A Cameron1, L Dziukas, A Hadj

  • 1Royal Melbourne Hospital, Parkville, Victoria, Australia. PAC@mis.medrmh.unimelb.edu.au

The Australian and New Zealand Journal of Surgery
|May 8, 1998
PubMed
Summary
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Traumatic aortic transection is rare in surviving trauma patients. This study found an annual incidence of 13 per million in Victoria, with improved diagnosis and management strategies needed.

Area of Science:

  • Trauma Surgery
  • Cardiovascular Surgery
  • Public Health

Background:

  • Traumatic aortic transection is an uncommon but severe injury in trauma patients who survive to reach hospital.
  • Understanding the incidence and outcomes of this injury is crucial for improving patient care.

Purpose of the Study:

  • To conduct a population-based review of traumatic aortic transection in Victoria.
  • To determine the incidence, management, and outcomes of patients with this injury.

Main Methods:

  • Utilized data from the Victorian Major Trauma Study (VMTS) and coronial data from the Federal Office of Road Safety (FORS).
  • Reviewed 1874 patients with blunt trauma and Injury Severity Score (ISS) > 15 over two 2-year periods.
  • Analyzed incidence based on state population and coronial data.

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Main Results:

  • Identified 19 patients with traumatic aortic transection who reached hospital alive over a 2-year period.
  • Eight patients survived to leave hospital, with four having no disability.
  • Reported an annual incidence of 13 per million, lower than previously reported studies.
  • Confirmed the utility of chest X-ray in diagnosis and highlighted the frequent occurrence of associated injuries.

Conclusions:

  • The study highlights the need for direct referral of severe chest injury patients to cardiothoracic facilities.
  • Suggests increased utilization of transoesophageal echocardiography for diagnosis.
  • Recommends considering immediate laparotomy and thoracotomy in select patients.