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Information about Traumatic Aortic Rupture


Classification & external resources
The aorta, shown in red
ICD-10S25.0, S35.0
ICD-9901.0, 902.0
Traumatic aortic rupture, also called traumatic aortic disruption or transection, is a condition in which the aorta, the largest artery in the body, is torn or ruptured as the result of trauma. The condition is frequently fatal due to the profuse bleeding that results from the rupture. Since the aorta branches directly from the heart to supply blood to the rest of the body, the pressure within it is very great, and blood may be pumped out of a tear in the blood vessel very rapidly. This can quickly result in shock and death. Thus traumatic aortic rupture is a common killer of victims of automotive accidents and other traumas,[1] with up to 18% of deaths that occur in automobile collisions being related to the injury.[2] In fact, aortic disruption due to blunt chest trauma is the second leading cause of injury death (behind traumatic brain injury).[3]

Symptoms

The condition is difficult to detect and may go unnoticed. Most patients have no symptoms. However, a minority of patients may be hoarse, find it difficult to breathe or speak, or have shortness of breath, or have chest or upper back pain.[1] Diagnosis is further complicated by the fact that many patients with the injury experienced multiple other serious injuries as well,[4] so the attention of hospital staff may be distracted from the possibility of aortic rupture.

The preferred method of diagnosis is aortography. Though not completely reliable, chest X-rays are used to diagnose the condition.

Features

The injury is usually caused by high speed impacts such as those that occur in vehicle collisions and serious falls.[1] It may be due to different rates of deceleration of the heart and the aorta, which is in a fixed position.[5]

By far the most common site for tearing in traumatic aortic rupture is the aortic isthmus, near where the left subclavian artery branches off from the aorta.[6][7]

The aorta may also be torn at the point where it is connected to the heart. The aorta may be completely torn apart from the heart, but patients with such injuries very rarely survive for very long after the injury; thus it is much more common for hospital staff to treat patients with partially torn aortas.[1] When the aorta is partially torn, it may form a "pseudoaneurysm". In patients who do live long enough to be seen in a hospital, a majority have only a partially torn blood vessel, with the layer called the adventitia still intact.[2] In some of these patients, the adventitia and nearby structures within the chest may serve to prevent severe hemorrhage.[2]

Treatment

Traumatic aortic rupture is treated with surgery. However, morbidity and mortality rates for surgical repair of the aorta for this condition are among the highest of any cardiovascular surgery.[3] For example, surgery is associated with a high rate of paraplegia,[8] because the spinal cord is very sensitive to ischemia (lack of blood supply), and the nerve tissue can be damaged or killed by the interruption of the blood supply during surgery.

Since a high blood pressure could exacerbate the tear in the aorta or even separate it completely from the heart, which would almost inevitably kill the patient, hospital staff take measures to keep a patient's blood pressure low.[1] Such measures include giving pain medication, keeping the patient calm, and avoiding procedures that could cause gagging or vomiting.[1]

Prognosis

Death occurs immediately after traumatic rupture of the thoracic aorta 75% to 90% of the time since bleeding is so severe, and 80 to 85% of patients die before arriving at a hospital.[2] Though there is a concern that a small, stable tear in the aorta could enlarge and cause complete rupture of the aorta and heavy bleeding, this may be less common than previously believed as long as the patient's blood pressure does not get too high.[2]

See also

References

1. ^ Schrader L, Carey MJ (2000). Traumatic Aortic Rupture. The Doctor Will See You Now. interMDnet Corp.. Retrieved on 2007-07-21.
2. ^ Rousseau H, Soula P, Perreault P, et al (1999). "Delayed treatment of traumatic rupture of the thoracic aorta with endoluminal covered stent". Circulation 99 (4): 498-504. PMID 9927395. 
3. ^ Plummer D, Petro K, Akbari C, O'Donnell S (2006). "Endovascular repair of traumatic thoracic aortic disruption". Perspectives in vascular surgery and endovascular therapy 18 (2): 132-9. DOI:10.1177/1531003506293453. PMID 17060230. 
4. ^ Vloeberghs M, Duinslaeger M, Van den Brande P, Cham B, Welch W (1988). "Posttraumatic rupture of the thoracic aorta". Acta Chir. Belg. 88 (1): 33-8. PMID 3376665. 
5. ^ Rittenhouse EA, Dillard DH, Winterscheid LC, Merendino KA (1969). "Traumatic rupture of the thoracic aorta: a review of the literature and a report of five cases with attention to special problems in early surgical management". Ann. Surg. 170 (1): 87-100. PMID 5789533. 
6. ^ Phillips BJ (2001). "Traumatic Rupture Of The Thoracic Aorta: An Endoluminal Approach". The Internet Journal of Thoracic and Cardiovascular Surgery 4. ISSN 1524-0274. 
7. ^ McKnight JT, Meyer JA, Neville JF (1964). "Nonpenetrating Traumatic Rupture of the Thoracic Aorta". Ann. Surg. 160: 1069-72. PMID 14246145. 
8. ^ Attar S, Cardarelli MG, Downing SW, et al (1999). "Traumatic aortic rupture: recent outcome with regard to neurologic deficit". Ann. Thorac. Surg. 67 (4): 959-64; discussion 964-5. PMID 10320235. 

External links

 •  • [ e]
Injuries, other than fractures, dislocations, sprains and strains (, )
Head (head injury) and neckBlack eye - Traumatic brain injury (Concussion, Cerebral contusion, Epidural hematoma, Subdural hematoma, Subarachnoid hemorrhage) - Brachial plexus lesion
Thorax (chest trauma)Traumatic aortic rupture - Pneumothorax - Hemothorax - Hemopneumothorax
Abdomen, lower back, lumbar spine and pelvisRuptured spleen
Shoulder and upper armRotator cuff tear
GeneralBruise - Spinal cord injury
For other uses of "ICD", see ICD (disambiguation).


The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD
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List of ICD-10 codes. The version for 2007 is available online at [1]

Chapter Blocks Title
I Certain infectious and parasitic diseases
II Neoplasms
III Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
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For other uses of "ICD", see ICD (disambiguation).


The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD
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The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. These codes are in the public domain.

See also


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The aorta (generally pronounced [eɪˈɔːtə] or "ay-orta") is the largest artery in the human body, originating from the left ventricle of the heart and bringing oxygenated blood to all parts of the body in the systemic circulation.
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Arteries are muscular blood vessels that carry blood away from the heart.[1] All arteries, with the exception of the pulmonary and umbilical arteries, carry oxygenated blood.

The circulatory system is extremely important for sustaining life.
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Bleeding, technically known as hemorrhage (American English) or haemorrhage (British English) is the loss of blood from the circulatory system.[1] Bleeding can occur internally, where blood leaks from blood vessels inside the body or externally, either
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heart is a muscular organ responsible for pumping blood through the blood vessels by repeated, rhythmic contractions, or a similar structure in the annelids, mollusks, and arthropods.
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Blood is a specialized biological fluid consisting of red blood cells (also called RBCs or erythrocytes), white blood cells (also called leukocytes) and platelets (also called thrombocytes) suspended in a complex fluid medium known as blood plasma.
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Shock
Classification & external resources

ICD-10 many incl. R 57.
ICD-9 785

DiseasesDB 12013
MedlinePlus 000039
eMedicine emerg/531   med/285 emerg/533

MeSH D012769

For other uses, see Shock.

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car accident or car crash is an incident in which an automobile collides with anything that causes damage to the automobile, including other automobiles, telephone poles, buildings or trees, or in which the driver loses control of the vehicle and damages it in some other
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Chest trauma (or thoracic trauma) is a serious injury of the chest. Thoracic trauma is a common cause of significant disability and mortality. Thoracic injuries account for approximately 25% of all trauma-related deaths.
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MeSH D001930

Traumatic brain injury (TBI), traumatic injuries to the brain, also called intracranial injury, or simply head injury, occurs when a sudden trauma causes brain damage.
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X-rays (or Röntgen rays) are a form of electromagnetic radiation with a wavelength in the range of 10 to 0.01 nanometers, corresponding to frequencies in the range 30 PHz to 30 EHz. X-rays are primarily used for diagnostic radiography and crystallography.
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In human anatomy, the subclavian artery is a major artery of the upper thorax that mainly supplies blood to the head and arms. It is located below the clavicle, hence the name. There is a left subclavian and a right subclavian.
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For the botany term, see adventitious.


Adventitia is the outermost connective tissue covering of any organ, vessel, or other structure.
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Bleeding, technically known as hemorrhage (American English) or haemorrhage (British English) is the loss of blood from the circulatory system.[1] Bleeding can occur internally, where blood leaks from blood vessels inside the body or externally, either
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In medicine, epidemiology and actuarial science, the term morbidity can refer to
  • the state of being diseased (from Latin morbidus: sick, unhealthy),
  • the degree or severity of a disease,
  • the prevalence of a disease: the total

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Mortality rate is a measure of the number of deaths (in general, or due to a specific cause) in some population, scaled to the size of that population, per unit time. Mortality rate is typically expressed in units of deaths per 1000 individuals per year; thus, a mortality rate of
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MeSH D010264

Paraplegia is an impairment in motor and/or sensory function of the lower extremities. It is usually the result of spinal cord injury or a congenital condition such as spina bifida which affects the neural elements of the spinal canal.
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spinal chord is a thin, tubular bundle of nerves that is an extension of the central nervous system from the brain and is enclosed in and protected by the bony vertebral column.
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In medicine, ischemia (Greek ισχαιμία, isch- is restriction, hema or haema is blood) is a restriction in blood supply
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Blood pressure (strictly speaking: vascular pressure) refers to the force exerted by circulating blood on the walls of blood vessels, and constitutes one of the principal vital signs.
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An analgesic (colloquially known as a painkiller) is any member of the diverse group of drugs used to relieve pain (achieve analgesia). The word analgesic derives from Greek an- ("without") and -algia ("pain").
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Emesis redirects here. For the genus of metalmark butterflies, see Emesis (butterfly). Heaving redirects here. For the up-and-down motion, see heave.

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Chest trauma (or thoracic trauma) is a serious injury of the chest. Thoracic trauma is a common cause of significant disability and mortality. Thoracic injuries account for approximately 25% of all trauma-related deaths.
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Aortic dissection
Classification & external resources

Dissection of the aorta descendens (3), which starts from the left subclavian artery, reaching to the abdominal aorta (4). Aorta ascendens (1) and aortic arch (2) are not involved.
ICD-10 I 71.
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digital object identifier (or DOI) is a permanent identifier given to a document, which is not related to its current location. A typical use of a DOI is to give a scientific paper or article a unique identifying number that can be used by anyone to locate details of the paper, and
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An ISSN, or International Standard Serial Number, is a unique eight-digit number used to identify a print or electronic periodical publication. The ISSN system was adopted as international standard ISO 3297 in 1975. The TC 46/SC 9 is responsible for the standard.
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head of an animal is the rostral part (from anatomical position) that usually comprises the brain, eyes, ears, nose, and mouth (all of which aid in various sensory functions, such as sight, hearing, smell, and taste).
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