Computed tomography evaluation of traumatic rupture of the thoracic aorta: an outcome study.
OBJECTIVE
[corrected] To assess the long-term outcome of blunt trauma patients with suspected thoracic aortic or great vessel injury that was evaluated with contrast-enhanced chest computed tomography (CT).


METHODS
We studied the outcome of 278 consecutive patients who received contrast-enhanced CT for blunt chest trauma with computerized searches of the regional trauma database, hospital medical records, universal government medical coverage plan billing records, and regional vital statistics databases. Data retrieved included patient demographics, mechanism of injury, status of the aorta and proximal great vessels at contrast-enhanced CT, hospital discharge diagnoses, and outpatient procedural billings with specific attention to aortic or great vessel injury. Median follow-up was 615 days following the traumatic event.


RESULTS
Six subjects demonstrated direct signs of aortic or proximal great vessel injury on contrast-enhanced chest CT, as follows: aortic pseudoaneurysm and intimal flap (n = 4), carotid artery dissection (n = 1), and aortic dissection (n = 1). All were surgically treated, except the patient with aortic dissection, who was treated medically. In the other subjects, contrast-enhanced CT was negative (n = 230) or showed isolated mediastinal hematoma (n = 42). The computerized searches of the medical databases showed that none of these 272 subjects had procedures for, or died from, aortic or great vessel injury during the follow-up period.


CONCLUSIONS
Computerized searches of medical databases found no evidence of missed thoracic aortic or proximal great vessel injury in blunt trauma patients who were evaluated with contrast-enhanced chest CT.
Ellis
Jennifer D
JD
Department of Radiology, Vancouver General Hospital, Vancouver, BC.
Mayo
John R
JR
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging* / Q000293:injuries; D001019:Aortic Rupture / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D003287:Contrast Media; D016208:Databases, Factual; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D013898:Thoracic Injuries / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000628:therapy
D003287:Contrast Media