Traumatic abdominal aortic false aneurysm

Case contributed by Andrew Lawson


Blunt abdominal trauma

CT performed after laparotomy.

Retroperitoneal hematoma in the upper abdomen surrounds the abdominal aorta also involves left perirenal space with thickening of pararenal fascia. 

A large volume pneumoperitoneum is also present.

A 3.5 mm outpouching from the left lateral wall of the upper abdominal aorta just inferior to the level of the celiac axis ( L1 level ) is located short distance anterior to a tiny arterial branch. This is the epicenter of the upper abdominal hematoma and may represent small false aneurysm either from traumatic transection or at the site of avulsion of a small aortic branch. No intimal dissection flap is identified.

Case Discussion

The false aneurysm could not be identified on the 5mm thick slices. Close review of the thins revealed the point of bleeding.

Repeat CTA one week later demonstrated spontaneous thrombosis of the tiny false aneurysm.

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