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Traumatic aortic rupture

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

Motorbike accident

Patient Data

Age: 30 years
Gender: Male

Chest

x-ray

Supine trauma chest radiograph showing widened mediastinum with deviation of the trachea to the right, depression of the left main bronchus, left apical pleural capping and increased density of the left hemithorax consistent with hemothorax. Combination of findings is highly suspicious for traumatic aortic rupture.   

ct

CT confirms aortic rupture with irregular circumferential pseudoaneurysm and large volume mediastinal hemorrhage and left hemothorax. 

Case Discussion

Typical chest x-ray appearance of traumatic aortic rupture. It is always worth remembering however that a normal chest x-ray does not exclude an aortic injury. Unfortunately this patient died before a repair could be attempted. The lack of other chest injuries suggests rapid deceleration of the body without direct trauma to the chest itself.    

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