Traumatic type B aortic dissection.
A 37-year-old man was referred with thoracic pain after a deceleration trauma. He also had a cerebral contusion and a wrist fracture. There were no sings of hypovolemic shock. Computerized tomography (CT) of the chest and transoesophageal echocardiography (TEE) demonstrated a type B aortic dissection originating just distal to the left subclavian artery. There was a patent false lumen without rupture or distal ischaemia. Conservative treatment was given. A paralytic ileus developed and abdominal complaints persisted for several months. Angiography showed normal patency of mesenteric vessels. On follow-up, 3 years after the accident a slight aortic dilation was found on CT thorax without development of a post-dissection aneurysm. Blunt thoracic injury to the aorta usually gives rise to aortic rupture in the region of the isthmus, which can be complete or partial. In the latter case a false aneurysm may develop. An intimal tear after blunt trauma leading to type B aortic dissection rarely occurs. General principles regarding treatment of type B dissection also apply to this particular condition.
Goverde
P
P
Department of Surgery, University Hospital of Antwerp, Belgium.
Van Schil
P
P
Delrue
F
F
d'Archambeau
O
O
Vanmaele
R
R
Eyskens
E
E
D000328:Adult; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000209:etiology*; D001013:Aorta, Thoracic / Q000293:injuries*; D001019:Aortic Rupture / Q000209:etiology*; D001027:Aortography; D006801:Humans; D008297:Male; D013898:Thoracic Injuries / Q000150:complications*; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications*