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[Management of seat-belt aorta in severe polytrauma: a review].

作者信息

Hornez E, Bourgouin S, Baudoin Y, Prunet B, Monchal T, Schlienger G, Meyrat L, Thouard H

机构信息

Service de chirurgie digestive et vasculaire, département d'anesthésie réanimation, hôpital d'Instruction des Armées, boulevard Sainte-Anne, Toulon, France.

出版信息

J Mal Vasc. 2011 Jul;36(4):237-42. doi: 10.1016/j.jmv.2011.05.002.

Abstract

Blunt trauma of the abdominal aorta is rare. Secondary to high-energy trauma, it is observed mainly in association with complex lesions. Evaluation of injury to the aorta must be a priority due to the risk of life-threatening massive hemorrhage. The clinical presentation can be quite obvious but also variable and often misleading. If in doubt, a systematic injected whole body scan is essential to diagnose aortic lesions. Hemorrhage or ischemia dictates emergency laparotomy. Opening the retroperitoneum increases the risk of infection if there is an associated gastrointestinal tract injury and may contraindicate use of arterial prostheses. Endovascular treatment can be proposed for less symptomatic lesions, including intimal dissection. Stents can be inserted via a femoral approach. In the event of juxtarenal dissection, there is a risk of renal artery thrombosis. Endovascular treatment is currently not recommended. This treatment can be delayed for a few days if necessary. Morbidity is low and long-term results are good.

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