Blunt trauma to the abdominal aorta.

This review of blunt trauma to the abdominal aorta is based on one case summary and 32 cases from the literature. Motor vehicle accidents caused about half of the reported cases. In 69% of the cases the diagnosis was made in the immediate or early period. Associated injuries were present in 71% of the cases. Most injuries occurred at the inferior mesenteric artery (33%) or the renal arteries (24%). Overall mortality was 27%. Lower extremity ischemia evident on physical examination may suggest the diagnosis. When blunt abdominal aortic injury is suspected without distal ischemia, aortography may be used to define or exclude the injury and further therapy. Only minimal intimal disruptions should be managed nonoperatively.