CASE 566 Published on 24.10.2000

Teaching Case

Section

Chest imaging

Case Type

Clinical Cases

Authors

M. Wintermark, P. Schnyder

Patient

26 years, male

Categories

No Area of Interest ; Imaging Technique CT, Digital radiography ;

No Procedure ; No Special Focus ;

Show more Show less

View full case Show related cases Notify admin

Clinical History

High-speed motorcycle accident

Differential Diagnosis List

Blunt traumatic dissection and thrombosis of the celiac artery extending from a diaphragmatic aortic lesion

Imaging Findings

26-year-old male driver involved in a high-speed motorcycle accident

Discussion

In 90% of cases, blunt traumatic aortic lesions lie at the level of the aortic isthmus. In less than 10% of cases, they involve the ascending aorta, just above the aortic valve, and may then be associated with cardiac injuries and/or coronary artery lesions, with subsequent hemopericardium and cardiac tamponade. Finally, in 2% to 3%, blunt aortic injuries are located at the level of the diaphragm. They are then associated with lesions of the diaphragm and the celiac and/or superior mesenteric artery.

References

[1] Feczko JD, Lynch L, Pless JE, Clark MA, McClain J, Hawley DA.
An autopsy case review of 142 nonpenetrating (blunt) injuries of the aorta.
J Trauma. 1992 Dec;33(6):846-9. (PMID: 1474626)

[2] Kodali S, Jamieson WR, Leia-Stephens M, Miyagishima RT, Janusz MT, Tyers GF.
Traumatic rupture of the thoracic aorta. A 20-year review: 1969-1989.
Circulation. 1991 Nov;84(5 Suppl):III40-6. (PMID: 1934437)

[3] Williams JS, Graff JA, Uku JM, Steinig JP.
Aortic injury in vehicular trauma.
Ann Thorac Surg. 1994 Mar;57(3):726-30. (PMID: 8147647)

[4] Wintermark M, Wicky S, Bettex D, et al Trauma of the mediastinum. In Schnyder P, Wintermark M. Radiology of blunt trauma of the chest. Springer, Berlin Heidelberg New York, pp 71-134 (2000).

Case information