Abstract
Background
Aortic transection, or aortic rupture, is a rare diagnosis in trauma patients and
carries a high mortality.
Case Report
We present the case of a 61-year-old man presenting to a Level I trauma center after
being struck by a motor vehicle, found to have an aortic transection. He was initially
hypotensive and resuscitated with blood products due to concern for hemorrhagic shock.
Aortic injury was suspected after chest x-ray study demonstrated a widened mediastinum.
Traumatic thoracic aortic transection with pseudoaneurysm was diagnosed on computed
tomography of the aorta, and the patient was taken to the operating room for thoracic
endovascular repair of the aorta.
Why Should an Emergency Physician Be Aware of This?
Diagnosis of aortic injury can be challenging, especially in trauma patients presenting
with hypotension. Aortic injury must be suspected in patients presenting after a high-velocity
mechanism injury. It is an uncommon cause of hemorrhagic shock in trauma patients
and must be considered even if other traumatic injuries are identified, as it commonly
occurs with other significant injuries. Although chest x-ray study can be useful,
a negative chest x-ray study does not rule out aortic injury. Aortic injury is a time-sensitive
diagnosis, and early identification is key to these patients surviving to receive
definitive management in the operating room.
Keywords
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Article info
Publication history
Published online: March 28, 2020
Accepted:
February 16,
2020
Received in revised form:
January 28,
2020
Received:
November 13,
2019
Footnotes
This case report does not reflect the views or opinions of the U.S. government, Department of Defense, U.S. Army, U.S. Air Force, or the San Antonio Uniformed Services Health Education Consortium Emergency Medicine (SAUSHEC EM) Residency Program.
Identification
Copyright
Published by Elsevier Inc.
