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Emergency Radiology

Erschienen in:

01.05.2006 | Case Report

A case of acute abdominal aortic dissection caused by blunt trauma

verfasst von: Milagros Martí, Inmaculada Pinilla, Franziska Baudraxler, María-José Simón, Gonzalo Garzón

Erschienen in: Emergency Radiology | Ausgabe 4/2006

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Abstract

We present the case of an 18-year-old man involved in a fall with blunt abdominal trauma. The patient had hypovolemic shock and findings of an acute abdomen. Initial computed tomography (CT) showed pulmonary contusion, pneumohemothorax, hemoperitoneum, hepatic contusion, right kidney laceration and vascular avulsion, rupture of the mesenteric vein, rupture of the right rectus muscle with bowel hernia, and infrarenal aortic dissection. There were no signs of limb or medullar ischemia. After hemodynamic stabilization and surgical repair of the associated lesions, the dissection was successfully treated with a self-expanding aortic Wallstent. Postprocedure CT showed a well-positioned patent stent and the patient was discharged asymptomatic. Percutaneous endovascular stent implantation is minimally invasive and seems to be a safe treatment for traumatic dissection of the abdominal aorta.

Berthet JP, Marty-Ané CH, Vecrapen R, Picard E, Mary H, Alric (2003) Dissection of the abdominal aorta in blunt trauma: endovascular or conventional surgical management? J Vasc Surg 38:997–1004PubMedCrossRef

Solovei G, Alame A, Bardoux J et al (1994) Paraplegia and dissection of the abdominal aorta after closed trauma. A propos of a case. Current review of the literature (1982–1993). J Chir (Paris) 131:236–244

Lock JS, Huffman A, Johnson RC (1987) Blunt trauma to the abdominal aorta. J Trauma 27:674–677PubMed

Fattori R, Napoli G, Lovato L, Russo V, Pacini D, Pierangeli A et al (2002) Indication for timing of, and results of catheter-based treatment of traumatic injury to the aorta. AJR Am J Roentgenol 179:603–609PubMed

Fisher RG, Hadlock F (1981) Laceration of the thoracic aorta and brachiocephalic arteries by blunt trauma: report of 54 cases and review of the literature. Radiol Clin North Am 19:91–110PubMed

Perchinsky M, Gin K, Mayo JR (1998) Trauma-associated dissection of the thoracic aorta. J Trauma 45:626–629PubMedCrossRef

Campbell DK, Austin RF (1969) Seat belt injury: injury of the abdominal aorta. Radiology 92:123–124PubMed

Nunn DB (1973) Abdominal aortic dissection following non penetrating abdominal trauma. Am Surg 39:177–179PubMed

Dajee H, Richardson JW, Iype MO (1978) Seatbelt aorta: acute dissection and thrombosis of the abdominal aorta. Surgery 85:263–267

10.

Clark JC, Milroy CM (2000). Injuries and deaths of pedestrians. In: Mason JK, Purdue BN (eds) The pathology of trauma, 3rd edn. Arnold, London, pp 17–29

11.

Picard E, Marty-Ane CH, Vernhet H, Sessa C, Lesnik A, Senac JP et al (1998) Endovascular management of traumatic infrarenal abdominal aortic dissection. Ann Vasc Surg 12:515–521PubMedCrossRef

12.

Peterson AH, Williams DM, Rodriguez JL, Francis IR (1995) Percutaneous treatment of a traumatic aortic dissection by balloon fenestration and stent placement. AJR Am J Roentgenol 164:1274–1276PubMed

13.

Nisihimura K, Kanaoka Y, Ikebuchi M, Hiroe T, Tachibana M, Ishiguro S et al (2000) J Vasc Surg 32:616–618CrossRef

14.

Alkadhi H, Wildermuth S, Desbiolles L, Schertler T, Crook D, Marincek B, Boehm T (2004) Vascular emergencies of the thorax after blunt and iatrogenic trauma: multi-detector row CT and three-dimensional imaging. Radiographics 24:1239–1255PubMedCrossRef

15.

Yoshida S, Akiba H, Tamakawa M et al (2003) Thoracic involvement of type A aortic dissection and intramural hematoma: diagnostic accuracy-comparison of emergency helical CT and surgical findings. Radiology 228:430–435PubMedCrossRef

16.

Marty-Ane CH, Alric P, Prudhomme M, Chircop R, Serres-Cousine O, Mary H (1996) Intravascular stenting of traumatic abdominal aortic dissection. J Vasc Surg 23:156–161PubMedCrossRef

17.

Vernhet H, Marty-Ane CH, Lesnik A, Chircop R, Serres-Cousine O, Picard E et al (1997) Dissection of the abdominal aorta in blunt trauma: management by percutaneous stent placement. Cardiovasc Intervent Radiol 20:473–476PubMedCrossRef

Titel: A case of acute abdominal aortic dissection caused by blunt trauma
verfasst von: Milagros Martí
Inmaculada Pinilla
Franziska Baudraxler
María-José Simón
Gonzalo Garzón
Publikationsdatum: 01.05.2006
Verlag: Springer-Verlag
Erschienen in: Emergency Radiology / Ausgabe 4/2006
Print ISSN: 1070-3004
Elektronische ISSN: 1438-1435
DOI: https://doi.org/10.1007/s10140-006-0473-0

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A case of acute abdominal aortic dissection caused by blunt trauma

Abstract

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