-
Pediatric Radiology 1991A retrospective review was undertaken to determine the incidence of, and radiologic findings associated with aortic rupture resulting from blunt chest trauma in...
A retrospective review was undertaken to determine the incidence of, and radiologic findings associated with aortic rupture resulting from blunt chest trauma in children. Records and imaging data of 54 consecutive pediatric patients admitted over a 2 year period to a pediatric trauma center after sustaining blunt chest trauma were reviewed. Four of 54 (7.4%) had a documented aortic tear. Plain films were evaluated for 7 radiographic signs described in the adult literature as sensitive indicators of aortic rupture, including abnormal aortic contour and mediastinal widening. Two groups of patients were defined: Group 1 (n = 4) had aortic rupture confirmed by angiography or operation and Group 2 (n = 50) with no angiographic investigation. All patients in Group 1 demonstrated mediastinal widening and abnormal aortic contour; however, 50 percent of patients in Group 2 had similar findings. Computed tomograms of the thorax where obtained were reviewed, including 1 patient from Group 1 and 6 patients from Group 2. The aortic tear was well demonstrated in the one patient from Group 1; however, the remaining computed tomograms were deemed inadequate for reliable exclusion of significant aortic injury. Plain chest radiographic findings in 5 consecutive children who underwent aortography in the two years subsequent to this series, including 2 additional patients with aortic rupture, were also reviewed, with similar results. In conclusion, traumatic aortic rupture in the pediatric population may be more common than previously reported. Plain film findings of aortic rupture in children are similar to those in adults, and are sensitive but non-specific. Currently, at least in our institution, this injury may be underinvestigated. Angiography remains the modality of choice in the diagnosis of aortic tears in children.(ABSTRACT TRUNCATED AT 400 WORDS)
Topics: Angiography; Aorta, Thoracic; Aortic Rupture; Child; Female; Humans; Incidence; Male; Retrospective Studies; Thoracic Injuries; Tomography, X-Ray Computed; Wounds, Nonpenetrating
PubMed: 1891255
DOI: 10.1007/BF02011477 -
European Journal of Cardio-thoracic... 1991A case of spontaneous non-traumatic rupture of the thoracic aorta in a hypertensive patient is presented. The clinical findings suggested acute aortic dissection, and a... (Review)
Review
A case of spontaneous non-traumatic rupture of the thoracic aorta in a hypertensive patient is presented. The clinical findings suggested acute aortic dissection, and a large pericardial effusion was detected by echocardiography. The typical angiographic features of aortic dissection were not found. Autopsy revealed a longitudinal intimal tear and a rupture in the postero-lateral aspect of the ascending aorta. No false lumen was seen in the ascending aorta. When acute intrapericardial or intrapleural bleeding develops with no evidence of aortic aneurysm or dissection, spontaneous aortic rupture should be suspected.
Topics: Aged; Aorta, Thoracic; Aortic Rupture; Aortography; Echocardiography; Female; Humans
PubMed: 1772683
DOI: 10.1016/1010-7940(91)90124-3 -
Journal of the American Veterinary... Dec 2018
Topics: Animals; Aortic Rupture; Diagnosis, Differential; Euthanasia, Animal; Female; Horse Diseases; Horses; Sinus of Valsalva
PubMed: 30668255
DOI: 10.2460/javma.253.12.1551 -
Archives of Surgery (Chicago, Ill. :... May 1986Anecdotal reports of chronic contained rupture of abdominal aortic aneurysms exist. Their existence and implications have been largely ignored. From March 1984 to March...
Anecdotal reports of chronic contained rupture of abdominal aortic aneurysms exist. Their existence and implications have been largely ignored. From March 1984 to March 1985, 24 patients required repair of an infrarenal abdominal aortic aneurysm. Four patients underwent emergent repair. The remaining 20 patients were evaluated with computed tomography electively. Seven patients (35%) were demonstrated to have a rupture of the aneurysm and a retroperitoneal hematoma on the computed tomographic scan. All of the patients had histories of back or flank pain; five patients continued to complain of mild pain on admission. In no case was shock, impending shock, or a decrease in the hemoglobin level present on admission. All patients were operated on within 24 hours of evaluation. At operation, rupture was noted with organized hematoma outside the aorta contained in a pseudoaneurysmal wall of retroperitoneal connective tissue. There was no intraperitoneal blood. There was no operative mortality and survival was 100% at six months. The CT scan evaluation had identified a subgroup of patients with aneurysms associated with chronic contained rupture.
Topics: Aged; Aorta, Abdominal; Aortic Rupture; Chronic Disease; Follow-Up Studies; Humans; Male; Middle Aged; Time Factors; Tomography, X-Ray Computed
PubMed: 3707332
DOI: 10.1001/archsurg.1986.01400050060007 -
Emergency Medicine Journal : EMJ Jul 2004Thoracic aortic rupture (TAR) is recognised as a cause of death in victims of blunt trauma. Immediate mortality is 85% but in the group who survive to reach hospital... (Review)
Review
Thoracic aortic rupture (TAR) is recognised as a cause of death in victims of blunt trauma. Immediate mortality is 85% but in the group who survive to reach hospital there is a reasonable chance of successful surgical repair. TAR can be remarkably occult and the emergency physician is paramount in making the initial diagnosis. If suggestive, but often subtle features are not recognised in the early phase they will go undetected until full rupture and death occurs. This article reviews the mechanism of injury and describes the signs and symptoms of TAR in the acute phase. Features suggestive of TAR on the initial primary survey chest radiograph are described. The use of this film as a screening tool, and of other imaging modalities, is discussed.
Topics: Aorta, Thoracic; Aortic Rupture; Aortography; Echocardiography, Transesophageal; Humans; Tomography, X-Ray Computed
PubMed: 15208221
DOI: No ID Found -
The Journal of Trauma Jan 1997
Topics: Adult; Aorta, Thoracic; Aortic Rupture; Exercise; Fatal Outcome; Humans; Male; Wounds, Nonpenetrating
PubMed: 9003273
DOI: 10.1097/00005373-199701000-00025 -
The Journal of Invasive Cardiology Feb 2024An 80-year-old woman who was an active smoker with neglected long-term hypertension, but no known previous aortic or connective tissue disorders, presented to the...
An 80-year-old woman who was an active smoker with neglected long-term hypertension, but no known previous aortic or connective tissue disorders, presented to the emergency department complaining of sudden chest pain associated with cardiogenic shock.
Topics: Female; Humans; Aged, 80 and over; Aortic Rupture; Aorta; Chest Pain; Emergency Service, Hospital; Shock, Cardiogenic
PubMed: 38335508
DOI: 10.25270/jic/23.00150 -
Deutsche Medizinische Wochenschrift... Oct 2000A 75-year-old man was admitted with increasing dyspnoea and recurrent left-sided chest pain, at first during exercise and later at rest. No cardiovascular risk factors...
HISTORY AND CLINICAL FINDINGS
A 75-year-old man was admitted with increasing dyspnoea and recurrent left-sided chest pain, at first during exercise and later at rest. No cardiovascular risk factors could be found. His past medical history revealed mastectomy and radiotherapy for breast cancer and an operation for benign prostate hyperplasia. At admission the patient was in very poor conditions with marked orthopnoea. Bilateral moist rales were heard over both lungs with a 3/6 diastolic murmur an cardiac auscultation.
INVESTIGATIONS
Anterolateral ST segment depression in the ECG and signs of pulmonary oedema in chest X-ray were also noted. Echocardiography discovered global reduced left ventricular contractility with aortic insufficiency (II degree) in mild aortic valve sclerosis. Coronary angiography demonstrated marked dilatation of the coronary arteries without stenosis. The ascending aorta was dilated without angiographic signs of a dissection.
DIAGNOSIS, TREATMENT AND COURSE
After medical treatment and a short period without symptoms the patient had to be resuscitated and died after a intense attack of dyspnoea and chest pain. The autopsy revealed a focal dissection of the ascending aorta with a small aortic rupture caused by idiopathic Erdheim's medial necrosis.
CONCLUSION
Erdheim's medical necrosis is an important cause of aortic dissection and aortic rupture. If symptoms of acute severe chest pain are present and a coronary syndrome can be excluded, possible disease of the aorta should be investigated. The reported case demonstrates the short time window between onset of symptoms and the necessary treatment.
Topics: Aged; Aorta; Aortic Rupture; Coronary Angiography; Dyspnea; Humans; Male; Necrosis; Syndrome; Tunica Media
PubMed: 11075252
DOI: 10.1055/s-2000-7697 -
The New England Journal of Medicine Apr 1972
Topics: Aged; Aortic Aneurysm; Aortic Rupture; Humans; Male
PubMed: 5025786
DOI: 10.1056/nejm197204062861415 -
The Thoracic and Cardiovascular Surgeon Feb 1980Twenty-six aortic ruptures were found in 107 autopsies of vehicular trauma victims. There were 21 ruptures discovered at the classical location. In 14 accidents aortic...
Twenty-six aortic ruptures were found in 107 autopsies of vehicular trauma victims. There were 21 ruptures discovered at the classical location. In 14 accidents aortic rupture occurred in car passengers, in 4 cases in pedestrians and in 2 cases in cyclists. The aortic rupture was always caused by a severe accident, marked by high speed collision, considerable degree of automobile destruction and severe associated injuries. Aortic rupture could be correlated to a severe compression trauma in all cases. In 14 victims the impact force ran from right ventro-caudal to left dorso-cranial. In 2 victims the impact ran from left ventro-cranial to right dorso-caudal and in one pedestrian from right ventro-cranial to left dorso-caudal. The theories proposed for explaining aortic rupture at the classical location are examined on the basis of the material presented. The importance of forces acting in a right ventro-caudal to left ventro-cranial direction in causing rupture is stressed.
Topics: Accidents, Traffic; Adolescent; Adult; Age Factors; Aged; Aortic Rupture; Child; Child, Preschool; Humans; Middle Aged; Pressure; Rib Fractures; Thoracic Injuries
PubMed: 6154340
DOI: 10.1055/s-2007-1022054