Acute Traumatic Aortic Disruption and Right Aortic Arch: A Fatal Diagnosis
Journal Title: International Journal of Medical Research & Health Sciences (IJMRHS) - Year 2016, Vol 5, Issue 9
Abstract
Acute traumatic aortic disruption occurs after forceful deceleration and usually due to motor accidents. Only 10 % to 15 % reach a treatment facility alive and a highly suspicious state is needed for timely diagnosis. Most time they suffer multiple associated lethal injuries. Asymptomatic and isolated right aortic arch is a rare anomaly of the aorta with a prevalence of 0.5% [3]. Its diagnosis is by radiologic studies. We present this patient to remember that the incidental right aortic arch and disruption may interpreted as the left side mediastinal rotation in radiography and so inadvertently lead to late diagnosis and a futile outcome. A 24-year old man was brought to emergency room following a motor accident. He had Glascow Coma Scale Score: 14-15/15 but with stable vital signs. After primary survey chest radiography, emergency abdominal sonography (eFAST) and brain CT scanning were requested. Spiral thoracoabdominal CT was also requested about seven hours after admission and when the patient entered an unstable hemodynamic phase. The primary survey was unremarkable. His chest radiography had left mediastinal rotation, which is opposite to what is seen pathologically in the condition of the traumatic aortic disruption, the right mediastinal rotation. His eFAST and brain CT were normal. The patient remained stable until seven hours after admission when the patient becomes unstable. Massive pleural effusion with aortic disruption and a right aortic arch was seen in thoracoabdominal CT. He transferred to the operation room but arrested during transfer. Massive hemothorax was seen during open cardiac massage. Cardiopulmonary resuscitation was unsuccessful. This may raises that in any blunt trauma patient with highly suspicious history for the great vessel injury, it may be better to consider the spiral chest CT scanning as the primary radiologic test for evaluation of the chest trauma and not waste the time or resources with rely simply on a chest radiography.
Authors and Affiliations
Shirvan Salaminia| Assistant Professor Department of Cardiac Surgery, Clinical Research Development Unit-Yasuj University of Medical Sciences, Yasuj, Iran, Shokoufeh Hassannia| Resident of General Surgery, Clinical Research Development Unit-Yasuj University of Medical Sciences, Yasuj, Iran, Zeinab Alizadeh| Assistant Professor Department of Anesthiology, Clinical Research Development Unit-Yasuj University of Medical Sciences, Yasuj, Iran, Corresponding Email: alizadeh.md6010@gmail.com
Keywords
Related Articles
- EP ID EP12052
- DOI -
- Views 295
- Downloads 8
STUDY OF SERUM MALONDIALDEHYDE, NITRIC OXIDE, VITAMIN E LEVELS IN PATIENTS WITH RHEUMATOID ARTHRITIS
Background: Rheumatoid arthritis (RA) is a chronic progressive autoimmune disorder characterized by symmetric erosive synovitis and sometimes shows multisystem involvement. The long-term outcome of the disease is chara...
SCREENING OF ANTIBIOTIC RESISTANT GRAM NEGATIVE BACTERIA AND PLASMID PROFILING OF MULTI-DRUG RESISTANT ISOLATES PRESENT IN SEWAGE ASSOCIATED WITH HEALTH CARE CENTERS
Background: Healthcare effluent acts as the store house of harmful infectious agents such as the pathogens and microorganisms possessing multiple drug resistant genes. Potential health risk includes spreading of diseas...
COLD AGGLUTININ INDUCED HEMOLYTIC ANEMIA IN A PATIENT WITH PULMONARY TUBERCULOSIS
Autoimmune hemolytic anemias (AIHA) are an uncommon group of disorders characterized by red cell destruction due to autoantibodies. Though usually idiopathic, AIHA is commonly associated with lymphoproliferative disord...
URIC ACID AND HYPERTENSION: DOES URIC ACID LICK THE JOINTS AND BITES THE HEART?
Background: Uric acid a metabolic end product of purine degradation is implicated in gout as aetiology. Its increased levels have also been associated with hypertension, cardiovascular morbidity and mortality. Few studi...
Investigating the Effect of Swedish massage on Thoracic Pain in Patients Undergoing Coronary Artery Bypass Graft Surgery
Pain is one of the common complications after coronary artery bypass graft surgery. The current study aimed to investigate the effect of Swedish massage on thoracic pain in patients undergoing coronary artery bypass gra...