Kantonsspital St.Gallen

[Traumatic aortic rupture: diagnosis using biplanar transesophageal echocardiography]

M Ritter, R Stocker, Hans Rickli, M Jakob, L Von Segesser & R Jenni

abstract 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.
citation 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.
type journal paper/review (Translation2::getLang(): unknown language "". Use Translation2::setLang() to set a default language.)
date of publishing 4-1995
journal title Z Kardiol (84/4)
ISSN print 0300-5860
pages 323-6
PubMed 7785306