Meghan Galvin Lubner MD, Presenter: Nothing to Disclose

Kathryn Ann Robinson MD, Abstract Co-Author: Nothing to Disclose

Christine O. Menias MD, Abstract Co-Author: Nothing to Disclose

Sanjeev Bhalla MD, Abstract Co-Author: Nothing to Disclose

The findings of traumatic injury to the thoracic aorta have been well described. The purpose of this project was to review the cases of traumatic injury to the abdominal aorta over the past five years and describe the imaging features, including common locations, direct and indirect findings.

A retrospective search of the trauma registry was performed for CT imaging of aortic injury following IRB approval. Cases included both thoracic and abdominal aortic injuries. These were further sorted and two groups of patients were selected, one with contiguous thoracic and abdominal aortic injury, and one with distinct abdominal aortic injury. The abdominal aorta was defined to extend from the perihiatal region through the iliac vessels. A total of 15 cases of abdominal aortic injury were found over roughly a five year time period. These cases were then reviewed by three readers of varying experience and the findings summarized.

33% of the patients selected had continuous thoracic and abdominal aortic injuries. The other 67% had non-contiguous injuries to the abdominal aorta, defined to extend from the peri-hiatal area (up to approx T7) to the level of the iliac bifurcation. Location: 47% juxta/infrarenal, 27% perihiatal, 20% involving length of abdominal aorta. Indirect findings: Retroperitoneal hematoma 67%, Stranding around vessels 93%, Hemoperitoneum 47%, Associated solid organ/bowel injuries 60%, Associated bony injuries (spine, sacrum, ribs) 93%, Shock 53%. Direct findings: Intramural hematoma 53%, Dissection flap 47%, Intimal injury 20%, pseudoaneurysm 27%, abrupt caliber change 87%, branch vessel injury 27% (renals, IMA, lumbar). Common mechanisms: MVC, restrained, MVC ejected, fall from height, pedestrian struck.

Abdominal aortic injury can be seen in the setting of trauma in the emergency department and CT can be used to rapidly and efficiently recognize and characterize the injury based on both direct and indirect findings, as well as catalog associated injuries.

CT is the primary detection method for abdominal aortic injury. Recognition of CT features of abdominal aortic injury is critical in making the diagnosis and guiding triage/management of the patient

Lubner, M, Robinson, K, Menias, C, Bhalla, S, CT Features of Traumatic Injury to the Abdominal Aorta.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5005808.html