[Traumatic aortic rupture: diagnosis using biplanar transesophageal echocardiography]
M Ritter, R Stocker, Hans Rickli, M Jakob, L Von Segesser & R Jenni
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abstract
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Acute aortic rupture is a typical consequence of severe blunt chest
trauma often associated with rapid deceleration in car accidents.
Initial diagnostic findings are often misleading and multiorgan
injuries add to the diagnostic complexity; therefore, the natural
history of acute rupture is usually fatal during the first 24 h
after injury if left untreated. Prompt and simple diagnosis is,
hence, of paramount importance for successful treatment of acute
aortic rupture. Transesophageal echocardiography, particularly with
a biplane or multiplane probe, currently represents the diagnostic
tool of choice to meet these criteria; because of its high
sensitivity and specificity transesophageal echocardiography will
replace aortography as "gold standard" for diagnosis of
acute aortic rupture. We report on a 47-year-old woman with severe
blunt thoraco-abdominal trauma resulting from a car accident; at
hospital admission abdominal injuries were predominant and diagnosis
of an acute rupture of the descending thoracic aorta was made only
about 18 h after admission using biplane transesophageal
echocardiography. Emergency surgical revision confirmed the
diagnosis of complete transsection of the descending thoracic aorta
immediately after the origin of the left subclavian artery; the site
of transsection was surrounded by a large hematoma. Despite
successful reconstruction of the descending thoracic aorta by means
of graft interposition, a recurrent local bleeding event lead to
complete circulatory destabilization and, finally, to the death of
the patient.
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citation
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Ritter M, Stocker R, Rickli H, Jakob M, Von Segesser L, Jenni R.
[Traumatic aortic rupture: diagnosis using biplanar transesophageal
echocardiography]. Z Kardiol 1995; 84:323-6.
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type
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journal paper/review (Translation2::getLang(): unknown language "".
Use Translation2::setLang() to set a default language.)
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date of publishing
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4-1995
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journal title
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Z Kardiol (84/4)
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ISSN print
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0300-5860
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pages
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323-6
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PubMed
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7785306
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