Verletzungen der Aorta abdominalis

Abdominal aortic injuries are a very rare form of traumatic aortic injury and are much less common than thoracic aortic injury.

Epidemiology

Aortic injury occurs in <1% of blunt trauma patients, with abdominal aortic injury representing only ~5% of all aortic injuries . Males are more frequently injured, with the median age ~30 years .

Pathology

Abdominal aortic injuries are most commonly from a deceleration in motor vehicle accidents and range from intimal tears/flaps (minimal aortic injury), pseudoaneurysm to aortic transection . Aortic wall rupture can be due to branch avulsion .

Location
Etiology
  • blunt trauma
    • motor vehicle collisions (~70%)
    • crush injuries (~20%)
  • penetrating trauma
  • iatrogenic trauma
Associations

Associated traumatic injuries in blunt abdominal aortic injury include :

Radiographic features

The radiographic features are not dissimilar to thoracic aortic injuries . The seatbelt sign is positive in ~35% of cases .

Treatment and prognosis

Most (~90%) abdominal aortic injuries are managed non-operatively. Those who require operative management, endovascular repair is more common . Mortality is reported at 30% .

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