FINDINGS: A small well-defined outpouching having a small mural calcification, is seen at the anteromedial aspect of the thoracic aorta at the site of the aortic isthmus, which is likely a ductus diverticulum. Aortic dissection with intimal flap is noted in the thoracic aorta commencing at the T8 level and extending inferiorly along the right anterolateral aspect of the whole abdominal aorta into the right common iliac artery, it’s both external and internal branches as well as the scanned proximal right femoral artery. It has a smaller false lumen and a larger true lumen; both of which are well-opacified. The coeliac trunk, superior mesenteric, right renal, and right common iliac arteries are arising from the false lumen. Partial occlusion of the right common iliac, external iliac, and scanned right femoral arteries and near-complete occlusion of the right internal iliac arteries are noted. A clear discrepancy is seen in the enhancement pattern of both kidneys (hypoperfused right kidney), which needs close follow-up. No gross solid abdominal visceral injury, intra-abdominal free fluid, or pneumoperitoneum is seen. Incidental finding of multiple diverticula along the descending colon without any radiological evidence of diverticulitis.
Mild fat stranding or soft tissue thickening is seen around the distal descending thoracic and proximal abdominal aorta. Bilateral lung contusions (more evident in the left lower lung), bilateral minimal pneumothoraces, mild bilateral pleural effusions, mild surgical emphysema in the left chest wall. Changes of partial collapse/consolidation are seen in the dependent portions of both lungs. Multiple bilateral posterior rib fractures (right 5th -8th and left 3rd -6th ribs). Slightly displaced fractures involving the spinous processes of T4-T8 vertebrae. Mild degenerative changes are seen in the thoracolumbar spine.
CONCLUSION: These findings are in keeping with post-traumatic Stanford type B aortic dissection.