Traumatic Rupture of the Thoracic Aorta—The Radiologist's Responsibility

Abstract

SUMMARY Traumatic rupture of the aorta is a lesion requiring prompt diagnosis and surgical treatment for optimum patient survival. Plain chest x‐rays, erect or supine, should be regarded as suggesting this diagnosis whenever a mediastinal abnormality is seen in the patient with severe chest trauma, and aortography should be performed. Aortography may be safely performed from the femoral artery if a cautious technique is used. Aortography produces unequivocal evidence of aortic rupture with precise anatomical localization.

Factors Predisposing to Development of Dissecting Aneurysm of the Aorta

“…22 Most blunt traumatic injury to the aorta results in transverse rupture and immediate exsanguinating death, but a few cases reveal rupture with retrograde or antegrade dissection of the arterial wall for varying lengths. [22][23][24] In the case described by Sherbon, obstruction was encountered just distal to the arch during retrograde femoral artery catheterization, and a hand injection of contrast media in this region showed a false aneurysm with no retrograde filling into the aortic arch. z4 At operation the intima and media of the upper descending aorta were completely transected, and continuity was maintained by the adventitia.…”