Blunt abdominal aortic injury – A hybrid approach to combined injuries

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Ohad Guetta ◽  
Gad Shaked ◽  
George Greenberg ◽  
Gilbert Sebbag ◽  
David Czeiger
Keyword(s):  
Motor Vehicle ◽  
Seat Belt ◽  
Hybrid Approach ◽  
Aortic Injury ◽  
Stent Deployment ◽  
Early Management ◽  
Vehicle Accidents ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
Seat Belt Injury

Blunt abdominal aortic injury (BAAI) is a relatively rare pathology, usually the result of a seat belt injury in motor vehicle accidents (MVA), mostly combined with other injuries. Time is a crucial factor for the successful early management of these cases. Hybrid operating theaters, which support the integration of surgical treatment and interventional radiology, provide opportunities to reduce the time-to-surgery for life threatening conditions. We report a case of a 24-year-old female who was involved in a high-kinematics MVA. On presentation she was hemodynamically stable but had a prominent seat belt sign and peritoneal signs. A computerized tomography (CT) scan revealed an intimal flap of the infra-renal aorta and a peri-aortic hematoma together with a suspected laceration of the small bowel. The patient was operated in a hybrid approach; emergent endovascular repair of the aortic injury with stent deployment immediately followed by an explorative laparotomy for the intestinal injury. Her postoperative course was uneventful. The hybrid staged approach allowed a clean and efficient repair of a potentially lethal aortic injury and addressing a contaminated injury in the same compartment, hence preventing redundant morbidity. With the advances and growing availability of endovascular techniques, the hybrid approach has to be an important component of trauma management in the modern era.

Acute aortic syndrome: traumatic aortic injury

ESC CardioMed ◽  
2018 ◽  
pp. 2605-2606
Author(s):  
Johnny Steuer ◽  
Mario Lachat
Keyword(s):  
Life Support ◽  
Motor Vehicle ◽  
Expectant Management ◽  
Aortic Injury ◽  
Advanced Trauma Life Support ◽  
Trauma Patients ◽  
Vehicle Accidents ◽  
Life Threatening ◽  
Extent Of Damage ◽  
Intimal Tear

Blunt traumatic thoracic aortic injury (BAI) is a life-threatening emergency, the second most common cause of death in trauma patients, outnumbered only by intracranial haemorrhage. BAI is most frequently related to sudden deceleration in motor vehicle accidents, and the injury most commonly occurs at points of fixation in the descending aorta. In clinical series, it is predominantly in the region of the aortic isthmus. As victims of high-impact collisions often have multiple injuries, they are initially managed according to the Advanced Trauma Life Support® (ATLS®) concept. With improved pre- and in-hospital resuscitation, expeditious computed tomography angiography on arrival to the hospital, and increased awareness of the condition, patients who survive the initial impact are more likely to undergo successful treatment. All traumatic aortic injuries are not equally severe, as the extent of damage to the aortic wall may vary from an intimal tear to complete transection and rupture. Serial imaging and expectant management is advocated in patients with only an intimal tear but no external contour abnormality, whereas repair is recommended in most other cases. In recent years, thoracic endovascular aortic repair has emerged as the preferable treatment of patients with BAI, regardless of age. The initial outcome is highly dependent on the severity of other injuries, and most deaths are unrelated to the aortic injury per se, once the stent graft is in place. Long-term survival in patients discharged from the primary hospital admission is excellent. Early reintervention is fairly common, whereas late reinterventions are very uncommon.

scholarly journals Blunt traumatic aortic injury: CT angiography images and short review of current literature

2021 ◽  
Vol 0 (Ahead of Print) ◽  
Author(s):  
Sok-Sithikun Bun ◽  
Duygu Ozgul ◽  
Yasin Guzel ◽  
Erol Aksungur
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Short Review ◽  
High Energy ◽  
Aortic Injury ◽  
Vehicle Accidents ◽  
Vehicle Accident ◽  
Threatening Condition ◽  
Life Threatening ◽  
Blunt Traumatic Aortic Injury

Blunt traumatic aortic injury in high-energy motor vehicle accidents is a rare but life-threatening condition. Proper treatment after prompt and accurate diagnosis is critical to reduce the death rate. The purpose of this article was to highlight the points to be considered in blunt traumatic aortic injury due to high-energy motor vehicle accident.

scholarly journals TEVAR versus open repair of blunt traumatic descending aortic injury in polytraumatic patients involved in motor vehicle accidents

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Imthiaz Manoly ◽  
Mohamed El Tahan ◽  
Maymoona Al Shuaibi ◽  
Fatimah Adel ◽  
Mohammed Al Harbi ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Hospital Stay ◽  
Open Repair ◽  
Motor Vehicle ◽  
Aortic Injury ◽  
Motor Vehicle Accidents ◽  
Time Interval ◽  
Vehicle Accidents ◽  
Severity Scores ◽  
The Mean

Abstract Background Thoracic endovascular aortic repair (TEVAR) is the standard-of-care for treating traumatic aortic injury (TAI). Few retrospective studies compared TEVAR to open repair in blunt traumatic aortic injury (BTAI). Our objectives were to compare the early outcomes of TEVAR for blunt traumatic descending aortic injury to open repair (OR) in polytraumatic patients involved in motor vehicle accidents (MVA). Results Between February 2005 and April 2017, 71 patients with TAI due to MVA presented to our institution. All patients with descending aortic injuries were considered for open repair (n = 41) or TEVAR (n = 30) if there was no contraindication. The primary outcome was mortality, and secondary outcomes were stroke, paraplegia, intensive care unit (ICU), and hospital stay. The mean age was 28.4 ± 10.1 years in the OR group and 33.3 ± 16.6 years in TEVAR-group (P = 0.13). The injury severity scores were 41 ± 10 in the OR group and 33 ± 17 in the TEVAR group (P = 0.03). Patients in the OR group underwent emergency repair with a mean time of 0.56 ± 0.18 days from arrival. The TEVAR group had a longer time interval between arrival and procedure (2.1 ± 1.7 days, P = 0.001). The OR group had more blood transfusion (24 (58.5%) vs. 8 (27.5%), P = 0.002), renal impairment (6 (14.6%) vs. 1 (5.50%), P = 0.23), and wound infection (21 (51.2%) vs. 3 (10%), P < 0.001). Three TEVAR patients had a perioperative stroke compared to two patients in the OR group (P = 0.64). There was no difference in the mean ICU (6 ± 8.9 vs. 5.3 ± 2.9 days; P = 0.1) or hospital stay (20.1 ± 12.3 vs. 20.1 ± 18.3, P = 0.62) between the two groups. There were four deaths in the OR group and none in the TEVAR group (P = 0.13). Conclusion The results of TEVAR were comparable with the open repair for traumatic aortic injury with good early postoperative outcomes. TEVAR repair could be associated with lower mortality, blood transfusion, and infective complications. However, the complexity of the injury and technical challenges were higher in the open group.

CT features of blunt abdominal aortic injury: an infrequent but life-threatening event

2021 ◽  
Author(s):  
Eva Prado ◽  
Elena M. Chamorro ◽  
Alejandro Marín ◽  
Carlos G. Fuentes ◽  
Zhao Chen Zhou
Keyword(s):  
Aortic Injury ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
Life Threatening Event ◽  
Ct Features

scholarly journals Risk and resilience factors of persons exposed to accidents

2016 ◽  
Vol 89 (2) ◽  
pp. 257-266
Author(s):  
Dana - Cristina Herta ◽  
Paula Brindas ◽  
Raluca Trifu ◽  
Doina Cozman
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accidents ◽  
Risk And Resilience ◽  
Reasons For Living ◽  
Vehicle Accidents ◽  
Physical Suffering ◽  
Accident Victim ◽  
Life Threatening ◽  
Resilience Factors ◽  
Reasons For Living Inventory

Background and aims. Resilience encompasses factors promoting effective functioning in the context of adversity. Data regarding resilience in the wake of accidental trauma is still scarce. The aim of the current study is to comparatively assess adaptive, life – promoting factors in persons exposed to motor vehicle accidents (MVA) vs. persons exposed to other types of accidents, and to identify psychological factors of resilience and vulnerability in this context of trauma exposure.Methods. We assessed 93 participants exposed to accidents out of 305 eligible patients from the Clinical Rehabilitation Hospital and Cluj County Emergency Hospital. The study used Reasons for Living Inventory (RFL) and Life Events Checklist. Scores were comparatively assessed for RFL items, RFL scale and subscales in participants exposed to motor vehicle accidents (MVA) vs. participants exposed to other life – threatening accidents.Results. Participants exposed to MVA and those exposed to other accidents had significantly different scores in 7 RFL items. Scores were high in 4 out of 6 RFL subscales for both samples and in most items comprising these subscales, while in the other 2 subscales and in some items comprising them scores were low.Conclusions. Low fear of death, physical suffering and social disapproval emerge as risk factors in persons exposed to life – threatening accidents. Love of life, courage in life and hope for the future are important resilience factors after exposure to various types of life – threatening accidents. Survival and active coping beliefs promote resilience especially after motor vehicle accidents. Coping with uncertainty are more likely to foster resilience after other types of life – threatening accidents. Attachment of the accident victim to family promotes resilience mostly after MVA, while perceived attachment of family members to the victim promotes resilience after other types of accidents.  

scholarly journals Traumatic Aortic Injury in a 3-Year-Old Child - A Case Report and Literature Review

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Aljohani M ◽  
◽  
Alanazi S ◽  
Keyword(s):  
Case Report ◽  
Significant Contribution ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Aortic Injury ◽  
Vehicle Accidents ◽  
Vehicle Accident ◽  
Pseudo Aneurysm ◽  
High Index Of Suspicion ◽  
Tomography Scan

This case report describes a case of aortic injury with pseudo-aneurysm in a 3-year-old Saudi boy following a motor vehicle accident. The diagnosis was suspected on computed tomography scan, and emergency surgery was performed. A Dacron graft was inserted to repair the injured aorta. Postoperatively, absent femoral, and distal pulses were noted, and thromboembolectomy was performed with good outcome. We believe that our study makes a significant contribution to the literature because it raises awareness of aortic injury and rupture in pediatric patients with multi-organ trauma following motor vehicle accidents. A high index of suspicion and early intervention are essential in improving outcomes.

Blunt abdominal trauma with uterine rupture and fetal demise

Trauma ◽  
2016 ◽  
Vol 19 (3) ◽  
pp. 219-221 ◽  
Author(s):  
Christina Lien ◽  
Aamna Ali ◽  
John Culhane
Keyword(s):  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Uterine Rupture ◽  
Motor Vehicle ◽  
Seat Belt ◽  
Fetal Loss ◽  
Fetal Demise ◽  
Vehicle Accidents ◽  
Pelvic Injuries ◽  
Minor Injuries

Traumatic uterine rupture is rare, occurring in 0.6% of blunt trauma cases, and usually results from very violent accidents in which patients usually also sustain other major injuries. Following severe blunt abdominal trauma, fetal loss can result from maternal hypotension or hypoxemia, placental abruption, maternal death, and uterine rupture. Although less common, fetal loss can also occur in minor injuries. We report a patient who sustained an isolated anterior uterine rupture with fetal demise without any associated abdominal or pelvic injuries. This case report highlights the importance of proper seat belt usage and placement because both can reduce maternal and fetal morbidity and mortality in motor vehicle accidents.

On Informing Women of Child Bearing Age about Seat Belt Risk during Pregnancy

2002 ◽  
Vol 46 (11) ◽  
pp. 943-946
Author(s):  
Kenya Freeman ◽  
Michael S. Wogalter
Keyword(s):  
Pregnant Women ◽  
Motor Vehicle ◽  
Seat Belt ◽  
Seat Belts ◽  
Third Trimester ◽  
Severe Injuries ◽  
Vehicle Accidents ◽  
Child Bearing ◽  
Seat Belt Use ◽  
Serious Injuries

Seat belts have been effective in reducing serious injuries and deaths in vehicular accidents. However, their use by women in the third trimester of pregnancy can cause placental damage and fetal injury or death in relatively minor motor vehicle accidents without severely injuring pregnant women. The lack of seat belt use in similar or more serious accidents could cause severe injuries or death to pregnant women from impacts within the cabin or from ejection, and in turn could lead to fetal injuries or deaths. The present study sought to determine whether women between the ages of 16 and 45 (child bearing age) would like to be informed of these risks. Ninety-nine of the 101 women surveyed indicated they would like to be informed of the risks, and that they would expect to find this information in the vehicle's owners manual. in dealing with the risks, some women indicated that they would wear the seatbelts and others indicated they would not. Most respondents indicated that they would reduce the risks by reducing their use of the vehicle during pregnancy. These results have implications for risk communications.

Clinical analysis of external laryngeal trauma

1994 ◽  
Vol 108 (3) ◽  
pp. 221-225 ◽  
Author(s):  
P. T. Yen ◽  
H. Y. Lee ◽  
M. H. Tsai ◽  
S. T. Chan ◽  
T. S. Huang
Keyword(s):  
Vocal Fold ◽  
Motor Vehicle ◽  
Clinical Analysis ◽  
Airway Patency ◽  
Laryngeal Trauma ◽  
Vehicle Accidents ◽  
Presenting Symptoms ◽  
Laryngeal Injury ◽  
Life Threatening ◽  
The Voice

AbstractThirty patients with external laryngeal trauma were analysed retrospectively. Injuries were mostly caused by motor vehicle accidents (car = 36.7 percent; motorcycle = 23.3 per cent). The main presenting symptoms and signs were hoarseness, neck tenderness, dysphagia, and neck emphysema. Sites of laryngeal injury included arytenoid swelling, vocal fold injury, soft tissue contusion or superficial mucosal laceration, cricoarytenoid dislocation, thyroid fracture, epiglottic fracture and mixed injuries. Treatment was varied depending on the severity of the injuries. Sixteen cases were managed conservatively by medical treatment; two cases received intubation; four cases were treated initially by tracheostomy; eight cases received surgical repair and/or reconstruction; 11 cases made a full recovery of the voice and 18 cases fair voice recovery due to either sustained vocal fold swelling or limitation of vocal fold movement. One case was graded as poor. Twenty-eight cases had good airway patency and two cases fair airway patency. A delay in the early detection of laryngeal trauma may precipitate into life-threatening airway problems, therefore prompt and accurate diagnosis should be followed immediately by skilful airway management.

Sign in / Sign up

Export Citation Format

Share Document