Traumatic aortic transection: Difference between revisions
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==Background== | ==Background== | ||
*Blunt traumatic mechanism, rapid deceleration | |||
*Pt often asymptomatic but die w/o warning (80% die at scene) | *Pt often asymptomatic but die w/o warning (80% die at scene) | ||
*Hypotension NOT from ruptured aorta (just die) | *Hypotension NOT from ruptured aorta (just die) | ||
Revision as of 13:09, 30 November 2015
Not to be confused with nontraumatic thoracic aortic dissection
Background
- Blunt traumatic mechanism, rapid deceleration
- Pt often asymptomatic but die w/o warning (80% die at scene)
- Hypotension NOT from ruptured aorta (just die)
- Need high suspicion to diagnose
Diagnosis
- CXR
- Widened mediastinum(>8cm on supine film)
- CT
- Good for aorta but not for branch vessels
- Aortography
- Gold standard
- 25% have complications (i.e. infection & hematoma)
Differential Diagnosis
Thoracic Trauma
- Airway/Pulmonary
- Cardiac/Vascular
- Musculoskeletal
- Other
Treatment
- Initial medical management similar to Nontraumatic thoracic aortic dissection
- Keep SBP <120, HR 60-80 w/ alpha/beta blockers, CCBs
- Surgical management for high grade injuries