Rupture of an abdominal aortic aneurysm following nonaccidental blunt abdominal trauma.
A 78-year-old woman presented to our trauma center with an initial, erroneous history of a ground-level fall. Further investigation revealed that the patient had been assaulted by her husband immediately prior to presentation. The initial abdominal examination was benign, and the patient was hemodynamically stable. The patient was found to have a large subdural hematoma (SDH). Following open evacuation of the SDH, the patient developed ongoing hemodynamic instability. Further evaluation with computed tomography of the abdomen and pelvis uncovered the diagnosis of a 6 cm abdominal aortic aneurysm (AAA) with a large retroperitoneal hematoma. The patient underwent emergent repair of the ruptured AAA. There were no other significant intra-abdominal injuries, and the patient had an uneventful recovery. This case highlights the need for thorough evaluation of the trauma patient and recognition of the possibility of coexistent AAA in the elderly trauma patient. We believe that this is the first reported case of a ruptured AAA following nonaccidental blunt abdominal trauma.
Chiriano
Jason
J
Division of Vascular Surgery, Department of Surgery, Loma Linda University Medical Center, 11175 Campus Street, Loma Linda, CA 92354, USA.
Killeen
J David
JD
Molkara
Afshin M
AM
Bianchi
Christian
C
Abou-Zamzam
Ahmed M
AM
D000007:Abdominal Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D001027:Aortography / Q000379:methods; D005260:Female; D006439:Hemodynamics; D006801:Humans; D013179:Spouse Abuse; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology