Traumatic aortic transection: Difference between revisions
(edit background) |
(Diagnosis) |
||
| Line 11: | Line 11: | ||
**Widened mediastinum(>8cm on supine film) | **Widened mediastinum(>8cm on supine film) | ||
*CT | *CT | ||
**Diagnostic study of choice | |||
**Good for aorta but not for branch vessels | **Good for aorta but not for branch vessels | ||
*Aortography | *Aortography | ||
**Gold standard | **Gold standard | ||
**25% have complications (i.e. infection & hematoma) | **25% have complications (i.e. infection & hematoma) | ||
**No longer routinely performed | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 13:12, 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
- Diagnostic study of choice
- Good for aorta but not for branch vessels
- Aortography
- Gold standard
- 25% have complications (i.e. infection & hematoma)
- No longer routinely performed
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