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For your convenience, find the Trauma List Archive Below

CT vs Angio Case

Andrew J Bowman trauma-list@trauma.org
Sun, 13 Oct 2002 21:01:40 -0500 

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Trauma List

As promised, more of the story.

42 year old male, motorcycle driver, hit a truck broadside at an
intersection.  Head injury and multiple, open extremity fractures.

Multiple area CT's including of chest.  2 views of chest CT are attached
which are the areas of interest.  Read by at least 2 radiologists and =
the CV
surgeon. Scanner is a new GE "light speed"

Official reading is as follows: "there is an identified irregularity of =
the
ascending aorta with the suggestion of a short segment dissection"

The study was repeated through this area and was again visualized as a
possible intimal flap dissection

No angiography, no TEE.

Pt was transferred from my ED to another hospital across town where pump
capability is located.

Median sternotomy was done.  Aorta explored.  No abnormality found.

Chest closed and attention turned to extremity injuries.  Pt did well.

I hope the CT quality is OK.  I got copies and then had to scan them in.

I had made the suggestion of doing an angio but was poo-pooed by all
involved.

Was told proximal aorta injuries are not seen well on angio.  Oh well.  =
It
appears they are seen too well with CT, so well they do not even have to =
be
there!

Andrew J. Bowman, RN, CEN, CCRN, NREMT-P
Patient Care Coordinator
Education Coordinator (Trauma & Emergency Cardiovascular Care)
Emergency Department
Home Hospital Campus
Greater Lafayette Health Services, Inc.
Home Hospital Campus
Lafayette, Indiana  47904
USA

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<DIV>Trauma List<BR><BR>As promised, more of the story.<BR><BR>42 year =
old male,=20
motorcycle driver, hit a truck broadside at an<BR>intersection.&nbsp; =
Head=20
injury and multiple, open extremity fractures.<BR><BR>Multiple area CT's =

including of chest.&nbsp; 2 views of chest CT are attached<BR>which are =
the=20
areas of interest.&nbsp; Read by at least 2 radiologists and the =
CV<BR>surgeon.=20
Scanner is a new GE "light speed"<BR><BR>Official reading is as follows: =
"there=20
is an identified irregularity of the<BR>ascending aorta with the =
suggestion of a=20
short segment dissection"<BR><BR>The study was repeated through this =
area and=20
was again visualized as a<BR>possible intimal flap dissection<BR><BR>No=20
angiography, no TEE.<BR><BR>Pt was transferred from my ED to another =
hospital=20
across town where pump<BR>capability is located.<BR><BR>Median =
sternotomy was=20
done.&nbsp; Aorta explored.&nbsp; No abnormality found.<BR><BR>Chest =
closed and=20
attention turned to extremity injuries.&nbsp; Pt did well.<BR><BR>I hope =
the CT=20
quality is OK.&nbsp; I got copies and then had to scan them in.<BR><BR>I =
had=20
made the suggestion of doing an angio but was poo-pooed by=20
all<BR>involved.<BR><BR>Was told proximal aorta injuries are not seen =
well on=20
angio.&nbsp; Oh well.&nbsp; It<BR>appears they are seen too well with =
CT, so=20
well they do not even have to be<BR>there!<BR><BR>Andrew J. Bowman, RN, =
CEN,=20
CCRN, NREMT-P<BR>Patient Care Coordinator<BR>Education Coordinator =
(Trauma &amp;=20
Emergency Cardiovascular Care)<BR>Emergency Department<BR>Home Hospital=20
Campus<BR>Greater Lafayette Health Services, Inc.<BR>Home Hospital=20
Campus<BR>Lafayette, Indiana&nbsp; 47904<BR>USA</DIV></BODY></HTML>

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