Periaortic hematoma on abdominal computed tomographic scanning as an indicator of thoracic aortic rupture in blunt trauma.
BACKGROUND
In our institution, we have noted an association between periaortic hematomas (PH) present on abdominal computed tomographic (CT) scans and patients with thoracic aortic rupture (TAR) in blunt trauma. This 5-year retrospective study determined the sensitivity and specificity of PH and left hemothorax seen on abdominal CT scan as an indicator of TAR.


METHODS
The trauma registry and records identified 54 blunt trauma patients who had a CT scan of the abdomen and an arch aortogram. Fourteen patients with TAR and 40 patients without TAR were selected for analysis. A digital photograph of an upper cut of the abdominal CT scan for each patient was examined by radiology staff for the presence or absence of PH and left hemothorax.


RESULTS
The sensitivity, specificity, positive predictive value, and negative predictive value of PH as a predictor of TAR were 88%, 99%, 97%, and 96%, respectively.


CONCLUSIONS
The finding of PH on CT scan of the abdomen in blunt trauma patients should alert the clinician to the high likelihood of thoracic aortic injury.
Curry
James Dylan
JD
Department of Surgery, University of Nevada School of Medicine, Las Vegas, Nevada 89102, USA.
Recine
Carl A
CA
Snavely
Elizabeth
E
Orr
Marian
M
Fildes
John J
JJ
D001013:Aorta, Thoracic / Q000293:injuries; D001019:Aortic Rupture / Q000000981:diagnostic imaging* / Q000209:etiology; D006406:Hematoma / Q000000981:diagnostic imaging* / Q000209:etiology; D006491:Hemothorax / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000000981:diagnostic imaging