Faraci R M, Westcott J L
Radiology. 1977 Jun;123(3):569-74. doi: 10.1148/123.3.569.
Two types of dissecting aortic hematoma occasionally follow blunt chest trauma. Localized subadventitial dissecting may occasionally accompany aortic laceration or transection. This subadventitial hematoma may itself rupture, or it may compress the true aortic lumen. In the presence of arteriosclerosis, classical (medial) dissecting hematoma may occur following blunt trauma. The trauma may be considerably less than that required to cause aortic rupture. Differentiation of the two forms may have practical significance. The treatment of aortic laceration is surgical repair, whether or not there is an associated subadventitial dissection. However, medial dissection following trauma is indistinguishable from spontaneous aortic dissection, and medical therapy may sometimes be the preferred method of treatment.
钝性胸部创伤偶尔会引发两种类型的主动脉夹层血肿。局限性外膜下夹层偶尔会伴随主动脉撕裂或横断。这种外膜下血肿本身可能破裂，也可能压迫主动脉真腔。在存在动脉硬化的情况下，钝性创伤后可能会发生典型的（中层）夹层血肿。引发创伤所需的力度可能远小于导致主动脉破裂所需的力度。区分这两种形式可能具有实际意义。无论是否伴有外膜下夹层，主动脉撕裂的治疗方法都是手术修复。然而，创伤后的中层夹层与自发性主动脉夹层难以区分，有时药物治疗可能是首选的治疗方法。
