An Autopsy Case Review of 142 Nonpenetrating (Blunt) Injuries of the Aorta

Feczko, John D.; Lynch, Lori; Pless, John E.; Clark, Michael A.; McClain, Joni L.; Hawley, Dean A.

doi:10.1097/00005373-199212000-00009

Cited by 206 publications

(118 citation statements)

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“…More recent studies find an incidence of 10% to 15 %. (6) This increase is possibly due to faster motor vehicles, marked decrease in fatal head injuries because of improved motor vehicle design, and the use of seatbelts. Although seatbelts reduce the frequency of fatal head injuries, they are associated with a higher incidence of blunt abdominal aortic injury and a high incidence of associated intraabdominal injuries.…”

Section: Discussionmentioning

confidence: 99%

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Abdominal Aortasında Aterom Plağı Bulunan Vakada Künt Travma Sonrası Infrarenal Abdominal Aorta Pseudoanevrizması: Vaka Sunumu ve Literatür değerlendirmesi

Koçoğulları¹

2009

JAEM

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Pseudoaneurysm of the abdominal aorta as a result of blunt trauma is uncommon, due in part to its protected position in the retroperitoneum. This report describes the case of a 58-year-old man with atheromatous aortic plaques with isolated infrarenal abdominal aortic pseudoaneurysm was diagnosed 5 weeks after blunt trauma. Key words: Pseudoaneurysm, Blunt trauma, Infrarenal Abdominal Aorta ÖZETKünt travmaya bağlı olarak gelişen abdominal aorta pseudoanevrizması retroperitonda aortanın bulunduğu pozisyon nedeniyle çok sık değildir. Bu vakada künt travmadan 5 hafta sonrası aterom palklı aortasında pseudoanevrizma gelişen 58 yaşında erkek hastayı tanımladık.

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Section: Discussionmentioning

confidence: 99%

“…Blunt aortic injuries are caused by motor vehicles in more than 70% of cases. (6) Traumatic pseudoaneurysms of the abdominal aorta are rare, because aortic injury frequently results in death. Traumatic aneurysm, also known as a false aneurysm or a pseudoaneurysm, results from traumatic disruption of a normal arterial wall.…”

Section: Discussionmentioning

confidence: 99%

Abdominal Aortasında Aterom Plağı Bulunan Vakada Künt Travma Sonrası Infrarenal Abdominal Aorta Pseudoanevrizması: Vaka Sunumu ve Literatür değerlendirmesi

Koçoğulları¹

2009

JAEM

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“…Aortic lesions represent the most lethal condition among chest injuries and are responsible for up to 40 % of fatalities occurring in traffic accidents [2,3]. Head-on and lateral motor vehicle accidents at speeds superior to 50 km/h, or associated with substantial car deformity, are the main cause (76 %) of blunt traumatic aortic injuries, followed by falls from heights ± usually exceeding 3 m ± and crush injuries [4,5,6,7].…”

Section: Epidemiology and Biomechanicsmentioning

confidence: 99%

“…Sudden antero-posterior or lateral deceleration superior to 80 g induces anterior cardiac displacement, leading to shearing forces, and sometimes rupture, at the aortic isthmic level [3,8]. Rapid vertical deceleration occurring in falls from height results in aortic arch compression against the anterior thoracic cage.…”

Section: Epidemiology and Biomechanicsmentioning

confidence: 99%

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Imaging of acute traumatic injuries of the thoracic aorta

2001

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Epidemiology and biomechanicsBlunt injuries of the thoracic aorta are met in 0.5±2 % of chest trauma patients admitted in emergency rooms alive [1,2]. Aortic lesions represent the most lethal condition among chest injuries and are responsible for up to 40 % of fatalities occurring in traffic accidents [2,3]. Head-on and lateral motor vehicle accidents at speeds superior to 50 km/h, or associated with substantial car deformity, are the main cause (76 %) of blunt traumatic aortic injuries, followed by falls from heights ± usually exceeding 3 m ± and crush injuries [4,5,6,7].Four mechanisms are hypothesized to explain blunt lesions to the thoracic aorta [8,9]. Sudden antero-posterior or lateral deceleration superior to 80 g induces anterior cardiac displacement, leading to shearing forces, and sometimes rupture, at the aortic isthmic level [3,8]. Rapid vertical deceleration occurring in falls from height results in aortic arch compression against the anterior thoracic cage. Aortic injuries with such biomechanics are thus located on the ascending aorta [10]. The ªwater-hammer effectº relates to a low thoracic or abdominal compression. The resultant sudden increase of the intra-aortic pressure may be responsible for ascending aortic injuries immediately above the aortic valve. A pressure peak of 80±350 kPa (600±2500 mmHg) is required to rupture a normal aorta [5]. Finally, the ªos-seous pinchº hypothesis assumes a compression of the heart and the aorta between the sternum and vertebral column, for instance, under a violent frontal impact against the steering wheel. The resultant left posterior displacement of the heart generates an aortic torsion, which may result in a traumatic aortic lesion, sometimes associated with thoracic vertebral fractures [11]. Eur. Radiol. (2002) Abstract Blunt traumatic aortic injuries are a major concern in the settings of high-speed deceleration accidents, since they are associated with a very high mortality rate; however, with prompt diagnosis and surgery, 70 % of the patients with a blunt aortic lesion who reach the hospital alive will survive. This statement challenges the emergency radiologist in charge to evaluate the admission radiological survey in a severe chest trauma patient. With a 95 % negative predictive value for the identification of blunt traumatic aortic lesions, plain chest film represents an adequate screening test. If aortography remains the gold standard, it tends, at least in hemodynamically stable trauma patients, to be replaced by spiral-CT angiography (SCTA), which demonstrates a 96.2 % sensitivity, a 99.8 % specificity, and a 99.7 % accuracy. In unstable patients, trans-esophageal echography (TEE) plays a major diagnostic role. Knowledge of advantages and pitfalls of these imaging techniques, as reviewed in this article, will help the emergency radiologist to choose the appropriate algorithm in the diagnosis of traumatic aortic injury, for each trauma patient.Keywords Wounds and injuriesT horacic injuries´Aortic ruptureD iagnostic imaging´X-ray CTÉ mergency tr...

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MDCT of Chest Trauma

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Schnyder

Multidetector-Row CT of the Thorax

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An Autopsy Case Review of 142 Nonpenetrating (Blunt) Injuries of the Aorta

Cited by 206 publications

References 0 publications

Abdominal Aortasında Aterom Plağı Bulunan Vakada Künt Travma Sonrası Infrarenal Abdominal Aorta Pseudoanevrizması: Vaka Sunumu ve Literatür değerlendirmesi

Abdominal Aortasında Aterom Plağı Bulunan Vakada Künt Travma Sonrası Infrarenal Abdominal Aorta Pseudoanevrizması: Vaka Sunumu ve Literatür değerlendirmesi

Imaging of acute traumatic injuries of the thoracic aorta

MDCT of Chest Trauma

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