Traumatic thoracic aortic laceration
The patient was in a high speed motor vehicle collision.
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There is an incomplete tear of the medial wall of the proximal descending thoracic aorta, distal to the left subclavian artery.
It is associated with an irregularly marginated pseudoaneurysm.
There is a large prevertebral and para-aortic hematoma extending from C7 to T9.
There is a large tear in the dome of the left diaphragm with intrathoracic herniation of the gastric fundus and surrounding abdominal fat.
Incidental note is made of a left chest tube in the fissure and a right chest tube in the posterior pleural space.
There is dependent atelectasis and contusion bilterally, greater on the left.
There are multiple rib fractures bilaterally with extrapleural hematoma at both apices greater on the left.
There are also fractures of the left transverse processes of T5 to T9.
1 case question available
Aortic tears or lacerations are injuries in which sections of the aorta are forcibly pulled apart. Transection represents a transverse circumferential tear of the aorta. This usually results in a hematoma. Mortality rate with these injuries is very high and patients with complete ruptures usually survive if there is containment of active bleeding by adventitia, thrombus, or mediastinal structures.
Supervised by: Dr. Geneviève Belley
Case courtesy of Dr. Joseph Cassulo
- Mai-Lan Ho, Fernando R. Gutierrez. Chest Radiography in Thoracic Polytrauma. (2012) American Journal of Roentgenology. 192 (3): 599-612. doi:10.2214/AJR.07.3324 - Pubmed
- V Raptopoulos, R G Sheiman, D A Phillips, A Davidoff, W E Silva. Traumatic aortic tear: screening with chest CT. (1992) Radiology. 182 (3): 667-73. doi:10.1148/radiology.182.3.1535879 - Pubmed
- Schumacher H, Schumacher BcD, Schumacher vTKH, Schumacher AJ, Schumacher. Acute Traumatic Aortic Tear: Open Versus Stent-Graft Repair. (2006) Seminars in vascular surgery. doi:10.1053/j.semvascsurg.2005.11.008 - Pubmed