thoracic aorta rupture

Question 1

what is the mechanism of injury?

Answer 1

decelerating force

Question 2

what are the clinical features?

Answer 2

contained haematoma: persistent hypotension

detected mainly by history, CXR changes

Question 3

what are the CXR changes?

Answer 3

• widened mediastinum
• trachea/ oesophagus right
• depression of left main stem bronchus
• widened paratracheal stripe/paraspinal interfaces
• space between aorta and pulmonary artery obliterated
• rib fracture/left haemothorax.

Question 4

how do you diagnose?

Answer 4

angiography, usually CT aortogram

Question 5

what is the treatment?

Answer 5

repair or replacement. ideally undergo endovascular repair

Question 6

what may survivors have?

Answer 6

incomplete laceration at the ligamentum arteriosum of the aorta