Traumatic aortic injury

Case contributed by Dr Vincent Tatco

Presentation

Multiple injuries secondary to fall.

Patient Data

Age: 45
Gender: Male
X-ray

Pulmonary vascularity is accentuated possibly due to congestion.

There is increased density in the left lower hemithorax for which atelectasis, pulmonary contusion and pleural effusion are considerations.

Heart is magnified.

Endotracheal tube, nasogastric tube and bilateral chest tubes are seen. 

CT

There is a saccular outpouching seen originating from the medial side of the proximal descending aorta 2.3 cm distal to the left subclavian artery with approximate dimensions of 2.6 x 1.5 x 2.6 cm. Given the history of trauma, the above finding is indicative of a pseudoaneurysm.

There is minimal pericardial effusion.

Atelectatic changes are seen in both lungs.

Soft tissue emphysema at the anterolateral chest wall is demonstrated.

DSA (angiography)

EVAR

Thoracic endovascular aortic repair (TEVAR) showing the aortic pseudoaneurysm and deployment of stent-graft within the descending aorta.

X-ray

Post-TEVAR chest radiograph showing the stent-graft along the descending aorta.

CT

Follow-up CT

Follow-up CT scan shows resolution of the previously reported pseudoaneurysm. Stent-graft is seen in place within the descending aorta without endoleak. 

Case Discussion

This is a case of traumatic aortic injury resulting to pseudoaneurysm, which was managed by thoracic endovascular aortic repair (TEVAR).

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Case information

rID: 48352
Case created: 2nd Oct 2016
Last edited: 11th Oct 2016
Systems: Vascular, Chest, Trauma
Inclusion in quiz mode: Included

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