Acute traumatic injury of the thoracic aorta with pseudoaneurysm after blunt chest trauma: Report of two cases (original) (raw)
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...
Chronic Thoracic Aortic Aneurysm Presenting 29 Years following Trauma
Case reports in surgery, 2015
Blunt, nonpenetrating injuries of the thoracic aorta are uncommon and associated with a high mortality rate within the first hour. Aortic injury is missed in 1-2% of patients that survive to hospital, and a chronic thoracic aortic aneurysm may subsequently form. We present a case in which a chronic thoracic aortic aneurysm was diagnosed 29 years following a significant motor vehicle accident. We discuss the epidemiology, presentation, and management of this uncommon consequence of blunt, nonpenetrating aortic injury. Our case illustrates an important clinical lesson; a past medical history of trauma should not be overlooked at any patient assessment.
Thoracic aortic aneurysms after blunt trauma
Turkish Journal of Trauma and Emergency Surgery, 2013
Aortic injury after blunt trauma that is missed during the first admission will soon be seen as a chronic aneurysm. The objective of this study is to show the importance of the diagnosis and appropriate treatment of these aneurysms. METHODS Between 2009 and 2012, 8 patients (mean age, 50±31 years) diagnosed with chronic traumatic aortic aneurysm were treated with either thoracic endovascular aortic repair (TEVAR) or conventional surgery 20 years on average after the trauma. RESULTS Treatments included TEVAR in four patients, conventional surgery in two patients, and hybrid intervention in one patient. One patient died postoperatively. One patient had an endoleak requiring a repeat TEVAR, which was successful. Brachial embolectomy was performed after placing the endovascular stent. No paraplegia or lower extremity ischemia was seen. One patient died preoperatively due to rupture of the aneurysm. CONCLUSION Chronic traumatic aortic aneurysms may cause general symptoms years after a blunt trauma. Aortic injury must always be considered in the assessment and follow-up of trauma patients.
Chronic, traumatic pseudoaneurysm of the ascending aorta
The Annals of Thoracic Surgery, 1992
Rupture of the ascending aorta is lethal in virtually all cases. In the recent literature, fewer than 9 cases of chronic, traumatic pseudoaneurysm of the ascending aorta have been documented. Reported herein is such a case, discovered incidentally and repaired successfully under cardiopulmonary bypass using a graft prosthesis. Aortogram remains the diagnostic method of choice in these patients.