Abdominal aortic injury

Last revised by Subhan Iqbal on 27 Dec 2021

Abdominal aortic injuries are a very rare form of traumatic aortic injury and are much less common than thoracic aortic injury

Aortic injury occurs in <1% of blunt trauma patients, with abdominal aortic injury representing only ~5% of all aortic injuries 1. Males are more frequently injured, with the median age ~30 years 5

Abdominal aortic injuries are most commonly from a deceleration in motor vehicle accidents and range from intimal tears/flaps (minimal aortic injury), pseudoaneurysm to aortic transection 3. Aortic wall rupture can be due to branch avulsion 5.

  • blunt trauma
    • motor vehicle collisions (~70%) 2,3
    • crush injuries (~20%) 3
  • penetrating trauma
  • iatrogenic trauma

Associated traumatic injuries in blunt abdominal aortic injury include 2,5:

The radiographic features are not dissimilar to thoracic aortic injuries 4. The seatbelt sign is positive in ~35% of cases 5.

Most (~90%) abdominal aortic injuries are managed non-operatively. Those who require operative management, endovascular repair is more common 2. Mortality is reported at 30% 2,3.

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