Aortic Trauma (Archived)

In the United States, trauma remains the leading cause of death in adults. Of all injuries sustained in trauma, the aortic injury is one of the most time-sensitive, life-threatening conditions, second only to head injury as a cause of death. The morbidity and mortality associated with traumatic aortic injury are about 30% within the first 24 hours. Some predisposing factors for traumatic aortic injury include penetrating chest injuries, deceleration injuries, and blunt chest trauma. There are no clinical findings specific to aortic injury. However, hypotension, external evidence of trauma, and altered mental status are common. Many patients with complete transection of the thoracic aorta die before arriving at the emergency department (ED). Those who survive arrival in the ED may have small tears or partial-thickness tears of the aortic wall with a pseudo-aneurysm formation. The survival of patients after traumatic aortic injury depends on a clinician’s high index of suspicion, rapid diagnosis, and prompt management.