II. Epidemiology

  1. Common cause of Traumatic sudden death
    1. Motor Vehicle Accident
    2. Fall from height

III. Pathophysiology

  1. Caused by decelerating forces and Blunt Chest Trauma
  2. Alive at presentation indicates only partial injury
    1. Injury occurs most often near ligamentum arteriosum
    2. Contiguous venous Laceration
      1. Responsible for part of mediastinal blood

IV. Imaging: Classic Chest XRay findings

  1. Widened mediastinum (8 cm)
  2. Obliteration of aortic knob
  3. Mediastinal structures deviated right
    1. Deviation of trachea to right
    2. Deviation of esophagus (or NG tube) to the right
    3. Deviation of the the right Bronchus to the right (as well as elevation)
  4. Loss of space between pulmonary artery and aorta
  5. Depression of left mainstem Bronchus
  6. Widened paratracheal stripe
  7. Widened paraspinal interfaces
  8. Pleural or apical cap present
  9. Left Pleural Effusion (Hemothorax)
  10. Associated injuries
    1. Rib Fracture of first or second rib
    2. Scapula Fracture

V. Diagnostics

  1. Aortogram (Gold standard)
    1. Expect <10% Aortograms positive if adequately ordered
  2. Transesophageal Echocardiogram
  3. CT Chest
    1. High False Negative Rate

VI. Management

  1. Emergent surgical intervention

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Ontology: Aortic Rupture (C0003496)

Definition (MSH) The tearing or bursting of the wall along any portion of the AORTA, such as thoracic or abdominal. It may result from the rupture of an aneurysm or it may be due to TRAUMA.
Concepts Disease or Syndrome (T047)
MSH D001019
English Aortic Rupture, Aortic Ruptures, Ruptures, Aortic, Rupture, Aortic, Aortic Rupture [Disease/Finding], aortic rupture, rupture aortic, Aortic rupture
Swedish Aortabristning
Japanese ダイドウミャクハレツ, 大動脈破裂, 破裂性大動脈瘤, 破裂大動脈瘤, 大動脈瘤-破裂, 大動脈瘤-破裂性
Czech aorta - ruptura, Ruptura aorty, ruptura aorty
Finnish Aorttaruptuura
Russian AORTY ANEVRIZMY RAZRYV, AORTY RAZRYV, АОРТЫ АНЕВРИЗМЫ РАЗРЫВ, АОРТЫ РАЗРЫВ
Croatian AORTNA RUPTURA
Spanish Rotura de la Aorta, Ruptura Aórtica, Rotura Aórtica, Ruptura de la Aorta, Rotura aórtica
Polish Pęknięcie aorty
Hungarian Aortarepedés
Italian Rottura aortica, Rottura dell'aorta
Norwegian Aortaruptur
Portuguese Ruptura aórtica, Ruptura Aórtica
Dutch aortaruptuur, Aortaruptuur, Ruptuur, aorta-
German Aortenruptur
French Rupture aortique, Rupture de l'aorte