Acute traumatic injury of the thoracic aorta with pseudoaneurysm after blunt chest trauma: Report of two cases (original) (raw)
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Injuries of thoracic aorta due to blunt trauma carry very high mortality rates and studies estimated that less than 2% of people who sustain it remain alive if they were not diagnosed and treated appropriately. Moreover, even those lucky few live with the risk of rupture of the Pseudoaneurysm that can develop years to decades after the causative trauma culminating in the fatal internal hemorrhage. This paper reports a case of a 72-years-old Libyan male who sustained a blunt chest injury and multiple rib fractures 55 years ago that resulted in a large pseudoaneurysm of the arch of aorta.
Combined left ventricular aneurysm and thoracic aortic pseudoaneurysm caused by blunt chest trauma
The Journal of Thoracic and Cardiovascular Surgery, 1999
Trauma resulting from a fall is associated with multiple injuries, including a great variety of cardiac and vascular lesions occurring alone or in combination. These include cardiac disruption, aortic rupture, vessel injury related to bone fractures, and retroperitoneal hemorrhage associated with a high mortality rate. We present here an extremely rare and difficult to manage situation in a patient with multisystemic injury, with the combination of blunt cardiac injury and disruption of the aorta leading to a ventricular aneurysm and formation of an aortic pseudoaneurysm.
Endovascular treatment for traumatic thoracic aortic pseudoaneurysm: a case report
Journal of Cardiothoracic Surgery, 2013
Cases of an endovascular treatment for traumatic aortic injury are extremely rare. A prompt diagnosis of traumatic thoracic aortic pseudoaneurysm through a 3-dimensional computed tomographic angiography of aorta and emergency repair are mandatory to rescue the life-threatening condition. An endovascular treatment is a trend for traumatic aortic injury because of lower invasivity, morbidity and mortality. We reported a rare case of traumatic aortic injury with thoracic aortic pseudoaneurysm definitively diagnosed by the reconstructional computed tomographic angiography of aorta and successfully treated with endovascular stent-graft.
Pseudoaneurysm of the Supracoeliac Aorta Following Blunt Trauma in a 83-Year-Old Woman
Acta Chirurgica Belgica, 2010
We report on the case of an 83-year-old hemiplegic female patient presenting with post-traumatic pseudoaneurysm of the supracoeliac aorta, treated with 38 mm ϫ 100 mm Talent Endoluminal Stent-Graft (Medtronic Inc., Santa Rosa, CA) using local anaesthesia. The patient was discharged on day 3 and the 8 month follow-up was without complications. Fig. 1 Contrast enhanced computerized tomography of the aorta revealing supracoeliac pseudoaneurysm (A and B).
Annals of Cardiac Anaesthesia, 2018
Traumatic aortic dissection following sudden deceleration injury requires urgent treatment as it may result in formation of aneurysm that may expand or rupture leading to catastrophe. Confirmation of diagnosis of aortic dissection often requires contrast-enhanced computed tomography (CECT) or magnetic resonance imaging, which is time-consuming. Often, there is a significant time lag between the CECT chest and surgical intervention. Progression of aortic dissections may be missed on CECT chest, which would be done in the initial hours after injury. Transesophageal echocardiography (TEE) is equally efficient for the diagnosis of aortic dissection. It may also provide additional information that can be very useful for the management. We report the case of a descending thoracic aortic dissection where TEE plays a crucial role during the surgical management of the patient.
Ejves Extra, 2006
Traumatic rupture of the thoracic aorta has a high mortality. The endovascular alternative has been considered for aortic repair in high-risk patients with multiple trauma. We report a case of a 20 year-old man who suffered a multiple trauma secondary to motor vehicle accident. Arteriography revealed the existence of a pseudoaneurysm at the origin of left common carotid artery. A short and immediate control of the thoracic aorta is needed in cases with active bleeding of the aorta when the patient is unstable. Endovascular treatment as a definitive repair or first control before performing surgical repair seems a good choice. Our experience in this patient suggests that the combined endovascular and surgical treatment can be a valuable therapeutic alternative when treating a blunt aortic lesion. It is less invasive surgery and avoids aortic cross-clamping, circulatory assistance and high dose heparinization. Further studies are required to determine the relevance of the endovascular treatment in the management of traumatic rupture of the aorta in young patients.
Atypical presentation of traumatic aortic injury
Case reports in emergency medicine, 2014
Background. Blunt thoracic aorta injury (BAI) is second only to head injury as cause of mortality in blunt trauma. While most patients do not survive till arrival at the hospital, for the remainder, prompt diagnosis and treatment greatly improve outcomes. We report an atypical presentation of BAI, highlighting the diagnostic challenges of this condition in the emergency department. Case Presentation. A previously well 25-year-old male presented 15 hours after injury hemodynamically stable with delirium. There were no signs or symptoms suggestive of BAI. Sonography showed small bilateral pleural effusions. Chest radiograph showed a normal mediastinum. Eventually, CT demonstrated a contained distal aortic arch disruption. The patient underwent percutaneous endovascular thoracic aortic repair and recovered well. Conclusion. This catastrophic lesion may present with few reliable signs and symptoms; hence, a high index of suspicion is crucial for early diagnosis and definitive surgical m...