What are the potential pitfalls/mimics of aortic transection?
Ductal remnants of the ductus arteriosum can cause a small diverticulum at the level of the aortic isthmus.
What percentage of patients with aortic transection survive to be scanned in ED?
Which anatomical point of the aorta is most at risk of transection?
The aortic isthmus.
There is a dissection flap which arises at the distal aortic arch with perfusion of false and true lumens. Immediately distal to this a further linear transmural density with intramural haematoma is seen and is consistent with a contained aortic transection. There is also a mediastinal haematoma.
There is a moderate-sized haematoma in the right pelvis and a filling defect in the right external iliac artery proximally in keeping with vessel injury, probably from traumatic dissection. The femoral artery is perfused distally. The stomach is fluid-filled and distended placing the patient at risk of aspiration.