Aortic transection

Case contributed by Dr Hani Makky Al Salam

Presentation

Passenger in motor vehicle collision

Patient Data

Age: Adult
X-ray

ETT and NGT are in expected positions.

Widened mediastinum, left apical cap and pleural effusion. In the setting of trauma this is highly suspicious of mediastinal hematoma. 

CT

There is abnormal contour of the proximal descending aorta just distal to the origin of the left subclavian artery (abnormal contour of aortic isthmus), associated with luminal filling defect (flap) and surrounding loss of fat planes in the mediastinum, consistent with mediastinal hematoma. There is bilateral pleural effusion, more on the left side, with collapse of the left lower lobe. No contrast extravasation seen. 

Interpretation: Features of acute aortic injury along with mediastinal and pleural hematoma. 

Case Discussion

Victim of motor vehicle collision with aortic transection.

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