II. Epidemiology
- Common cause of Traumatic sudden death
- Motor Vehicle Accident
- Fall from height
III. Pathophysiology
- Caused by decelerating forces and Blunt Chest Trauma
- Alive at presentation indicates only partial injury
- Injury occurs most often near ligamentum arteriosum
- Contiguous venous Laceration
- Responsible for part of mediastinal blood
IV. Imaging: Classic Chest XRay findings
- Widened mediastinum (8 cm)
- Obliteration of aortic knob
- Mediastinal structures deviated right
- Loss of space between pulmonary artery and aorta
- Depression of left mainstem Bronchus
- Widened paratracheal stripe
- Widened paraspinal interfaces
- Pleural or apical cap present
- Left Pleural Effusion (Hemothorax)
- Associated injuries
- Rib Fracture of first or second rib
- Scapula Fracture
V. Diagnostics
- CT Angiogram Chest (preferred)
- Preferred first-line study with Test Sensitivity
-
Aortogram
- Older XRay based study that is replaced by CT Angiogram
- Expect <10% Aortograms positive if adequately ordered
- Transesophageal Echocardiogram
VI. Management
-
Beta Blocker (e.g. Esmolol) if not hypotensive
- Goal Mean Arterial Pressure (MAP) 60-70 mmHg
- Goal Heart Rate 80 bpm
- Emergent surgical intervention
Images: Related links to external sites (from Bing)
Related Studies
| Definition (MSH) | The tearing or bursting of the wall along any portion of the AORTA, such as thoracic or abdominal. It may result from the rupture of an aneurysm or it may be due to TRAUMA. |
| Concepts | Disease or Syndrome (T047) |
| MSH | D001019 |
| English | Aortic Rupture, Aortic Ruptures, Ruptures, Aortic, Rupture, Aortic, Aortic Rupture [Disease/Finding], aortic rupture, rupture aortic, Aortic rupture |
| Swedish | Aortabristning |
| Japanese | ﾀﾞｲﾄﾞｳﾐｬｸﾊﾚﾂ, 大動脈破裂, 破裂性大動脈瘤, 破裂大動脈瘤, 大動脈瘤-破裂, 大動脈瘤-破裂性 |
| Czech | aorta - ruptura, Ruptura aorty, ruptura aorty |
| Finnish | Aorttaruptuura |
| Russian | AORTY ANEVRIZMY RAZRYV, AORTY RAZRYV, АОРТЫ АНЕВРИЗМЫ РАЗРЫВ, АОРТЫ РАЗРЫВ |
| Croatian | AORTNA RUPTURA |
| Spanish | Rotura de la Aorta, Ruptura Aórtica, Rotura Aórtica, Ruptura de la Aorta, Rotura aórtica |
| Polish | Pęknięcie aorty |
| Hungarian | Aortarepedés |
| Italian | Rottura aortica, Rottura dell'aorta |
| Norwegian | Aortaruptur |
| Portuguese | Ruptura aórtica, Ruptura Aórtica |
| Dutch | aortaruptuur, Aortaruptuur, Ruptuur, aorta- |
| German | Aortenruptur |
| French | Rupture aortique, Rupture de l'aorte |
Ontology: Injury of thoracic aorta (C0160690)
| Concepts | Injury or Poisoning (T037) |
| ICD9 | 901.0 |
| ICD10 | S25.0 |
| SnomedCT | 59568004 |
| English | Injury to thoracic aorta, injury of thoracic aorta (diagnosis), injury of thoracic aorta, Injury thoracic aorta, Injury of thoracic aorta, Thoracic aorta injury, Injury of thoracic aorta (disorder) |
| Dutch | thoracale aortaletsel, Letsel van thoracale aorta |
| German | Verletzung der Thorakalaorta, Verletzung der Aorta thoracica |
| Portuguese | Lesão traumática da aorta torácica |
| Spanish | Lesión traumática de la aorta torácica, injuria de la aorta torácica, lesión traumática de la aorta torácica (trastorno), lesión traumática de la aorta torácica |
| Japanese | 胸部大動脈損傷, ｷｮｳﾌﾞﾀﾞｲﾄﾞｳﾐｬｸｿﾝｼｮｳ |
| French | Lésion de l'aorte thoracique |
| Italian | Traumatismo dell'aorta toracica |
| Czech | Poranění hrudní aorty |
| Korean | 가슴 대동맥의 손상 |
| Hungarian | Mellkasi aorta sérülése |
Ontology: Injury of aorta (C0854391)
| Definition (NCI) | Damage to the aorta from traumatic or pathologic processes. |
| Definition (NCI_CTCAE) | A finding of damage to the aorta. |
| Concepts | Injury or Poisoning (T037) |
| ICD10 | S25.0 |
| SnomedCT | 444036008 |
| Italian | Traumatismo dell'aorta |
| Japanese | 大動脈損傷, ﾀﾞｲﾄﾞｳﾐｬｸｿﾝｼｮｳ |
| Czech | Poranění aorty |
| English | Aortic injury, Injury of aorta (disorder), Injury of aorta, Injury of aorta NOS, aortic injury, injury; aorta, aorta; injury, Aortic Injury |
| Spanish | lesión traumática de aorta (trastorno), lesión traumática de aorta, Lesión traumática de la aorta |
| Hungarian | Aorta-sérülés |
| Dutch | aorta; letsel, letsel; aorta, aortaletsel |
| Portuguese | Lesão traumática da aorta |
| French | Lésion aortique |
| German | Aortaverletzung |
