Blunt abdominal aortic injury

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Presentation transcript:

Blunt abdominal aortic injury Sherene Shalhub, MD, MPH, Benjamin W. Starnes, MD, Nam T. Tran, MD, Thomas S. Hatsukami, MD, Rachel S. Lundgren, MD, Christopher W. Davis, MD, Samantha Quade, MD, Martin Gunn, MBChB Journal of Vascular Surgery Volume 55, Issue 5, Pages 1277-1285 (May 2012) DOI: 10.1016/j.jvs.2011.10.132 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 A, Computed tomography angiography (CTA) demonstrates traumatic injury of the infrarenal abdominal aorta that begins below the origin of the inferior mesenteric artery (IMA) with reappearance of the flap near the aortic bifurcation. B, Aortogram demonstrates the filling defect caused by the aortic injury. C, Follow-up imaging shows of the endovascular stent placed to cover the injured area. Journal of Vascular Surgery 2012 55, 1277-1285DOI: (10.1016/j.jvs.2011.10.132) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 A, Bulky noncalcified clot is seen in the anterior wall of the upper abdominal aorta crossing the celiac trunk. B, A three-dimensional reconstruction shows the filling defect. Journal of Vascular Surgery 2012 55, 1277-1285DOI: (10.1016/j.jvs.2011.10.132) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 3 A, Image shows traumatic pseudoaneurysm (arrow) of the aorta presenting 2 weeks after the initial injury. B, Aortogram demonstrates the pseudoaneurysm. C, Follow-up imaging after stent graft placement (arrow). Journal of Vascular Surgery 2012 55, 1277-1285DOI: (10.1016/j.jvs.2011.10.132) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 4 A, An aortogram demonstrates active extravasation at the level of the celiac axis. B, A 32-mm Coda balloon (Cook, Bloomington, Ind) has been inserted at the level of the celiac axis. Journal of Vascular Surgery 2012 55, 1277-1285DOI: (10.1016/j.jvs.2011.10.132) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 5 This proposed algorithm incorporates workup and treatment for blunt abdominal aortic injury (BAAI) in the setting of blunt abdominal trauma and potential role for an intra-aortic occlusion balloon (IAOB) to obtain proximal control. CT, Computed tomography; CTA, computed tomography angiography; DPL, diagnostic peritoneal lavage; LIF, large intimal flap. Journal of Vascular Surgery 2012 55, 1277-1285DOI: (10.1016/j.jvs.2011.10.132) Copyright © 2012 Society for Vascular Surgery Terms and Conditions