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Traumatic Aortic Rupture

trauma-list@trauma.org trauma-list@trauma.org
Sun, 27 Jan 2002 18:46:20 EST 

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In a message dated 1/27/2002 9:41:25 AM Eastern Standard Time, 
kari.hansen@haukeland.no writes:


> 85 year old male pedestrian hit by a car (50 km/h).
> Arrives ED 50 min. after the accident: Syst BP: 114. Pulse:70 GCS:14.
> 20 min after admission: Syst BP: 70. Pulse 100 GCS:10 Chest X-ray shows a
> widened mediastinum.
> After another 30 min the patient dies (at the CT-lab!). Post mortem exam.
> shows rupture of aortae distal to left subclavian artery.
> 
> Some questions about traumatic aortic rupture (TAR):
> 1.  Most TAR occures at the location described in this case. What is the
> chance for another location (outside pericard)?
> 
> 2.  If our patient had been young and healthy (and with a TAR that 
> obviously
> was bleeding while in ED), what would have been the chance of saving his
> life if he had gone to the OR instead of the CT-lab?
> 
> 3.  When in the OR and you suspect a TAR but do not know the exact 
> location.
> Would you go for an left thoracotomy or a sternum split?
> 
> 4.  Some years ago aortography was considered the "Golden standard". What 
> is
> considered as the best diagnostic tool today: aortography, helical CT or
> transoesoph. sonosound? 
> 

Coould this patient survive under any algorithm?
sal

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<HTML><FONT FACE=arial,helvetica><BODY BGCOLOR="#ffffff"><FONT  style="BACKGROUND-COLOR: #ffffff" SIZE=2>In a message dated 1/27/2002 9:41:25 AM Eastern Standard Time, kari.hansen@haukeland.no writes:<BR>
<BR>
<BR>
<BLOCKQUOTE TYPE=CITE style="BORDER-LEFT: #0000ff 2px solid; MARGIN-LEFT: 5px; MARGIN-RIGHT: 0px; PADDING-LEFT: 5px">85 year old male pedestrian hit by a car (50 km/h).<BR>
Arrives ED 50 min. after the accident: Syst BP: 114. Pulse:70 GCS:14.<BR>
20 min after admission: Syst BP: 70. Pulse 100 GCS:10 Chest X-ray shows a<BR>
widened mediastinum.<BR>
After another 30 min the patient dies (at the CT-lab!). Post mortem exam.<BR>
shows rupture of aortae distal to left subclavian artery.<BR>
<BR>
Some questions about traumatic aortic rupture (TAR):<BR>
1.&nbsp; Most TAR occures at the location described in this case. What is the<BR>
chance for another location (outside pericard)?<BR>
<BR>
2.&nbsp; If our patient had been young and healthy (and with a TAR that obviously<BR>
was bleeding while in ED), what would have been the chance of saving his<BR>
life if he had gone to the OR instead of the CT-lab?<BR>
<BR>
3.&nbsp; When in the OR and you suspect a TAR but do not know the exact location.<BR>
Would you go for an left thoracotomy or a sternum split?<BR>
<BR>
4.&nbsp; Some years ago aortography was considered the "Golden standard". What is<BR>
considered as the best diagnostic tool today: aortography, helical CT or<BR>
transoesoph. sonosound? <BR>
</BLOCKQUOTE><BR>
<BR>
Coould this patient survive under any algorithm?<BR>
sal</FONT></HTML>

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