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Traumatic Aortic Disruption

Topic updated on 12/25/15 2:12pm

Introduction
  • Injury to the aorta as a result of trauma, most commonly deceleration
  • Location of injury
    • Most common at aortic isthmus
    • Occurs often where the aorta is fixed
      • at the cardiac root
      • at the attachment of the ligamentum arteriosum
      • at the passage through the diaphragm
Presentation
  • Symptoms
    • chest discomfort
Evaluation
  • CXR
    • widened mediastinum
    • obliteration of aortic nob
    • deviation of trachea to right 
    • obscuration of the AP window
    • depression of left main stem bronchus
    • deviation of esophagus (NG tube) to right
    • widened paratracheal stripe
    • presence of pleural or apical cap
    • left hemothorax 
    • fracture of 1st or 2nd rib or scapula
  • Transesophageal echocardiography (TEE)
  • Arteriography
    • Gold standard
  • CT
Treatment
  • Surgical repair


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Qbank (1 Questions)

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(M1.CV.108) A 39-year-old female was involved in a head-on collision motor vehicle accident. If she was found to have a traumatic rupture of the aorta, where along the path of the aorta is the most common site of injury? Topic Review Topic

1. Ascending aorta
2. Site of attachment of ligamentum arteriosum
3. Aortic isthmus
4. Descending aorta - Thoracic aorta
5. Abdominal aorta

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