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Travmaya Bağlı İntramural Aort Hematomu

Year 2013, Volume: 4 Issue: 1, 19 - 21, 01.01.2013

Abstract

Travmaya bağlı aort hasarı nadir görülür ve yaklaşık %30 mortalite
ile seyreder. Sıklıkla torasik aortada psödoanevrizma ve intramural hematom gözlenir. İntramural hematom, intimal yırtılma olmaksızın aort disseksiyonu olarak tanımlanmıştır. İntramural aort
hematomu oldukça nadir görülen, ölümcül potansiyele sahip bir
durumdur. TEE, BT, MRG ve multidetector BT kullanılarak hızlı ve
güvenilir şekilde tanıya varılabilir. Travmatik intramural aort hematomunun yönetimi literatürde yeterince tanımlanmamıştır.
Görüntüleme yöntemlerinin gelişmesi sayesinde nonkomplike,
stabil hastalarda intramural aort hematomu konservatif yöntemle
tedavi edilebilir. Bu makalede konservatif yöntemle tedavi edilen
travmatik intramural aort hematomu olan 36 yaşındaki yüksekten
düşme hastası sunulmuştur.

References

  • Fabian TC, Richardson JD, Croce MA, Smith JS Jr, Rodman G Jr, Kearney PA, et al. Prospective study of blunt aortic injury: Multicenter Trial of the American Association for the Surgery of Trauma. J Trauma 1997; 42: 374-803. [CrossRef]
  • Aladham F, Sundaram B, Williams DM, Quint LE. Traumatic aortic injury: computerized tomographic findings at presentation and after conser- vative therapy. J Comput Assist Tomogr 2010; 34: 388-94. [CrossRef]
  • Kocoogullari CU, Emmiler M, Saglam H, Yavuz Y, Yurumez Y, Cekirdekci A. Infrarenal Abdominal Aortic Pseudoaneurysm in a Case with Abdomi- nal Aortic Atheromatous Plaque after Blunt Trauma: A Case Report and Review of the Literature. JAEM 2009; 8: 56-9.
  • Krukenberg E. Beitrage zur Frage des Aneurysma dissecans. Beitr Pathol Anat Allg Pathol 1920; 67: 329-51.
  • Baikoussis NG, Apostolakis EE, Siminelakis SN, Papadopoulos GS, Goudevenos J. Intramural haematoma of the thoracic aorta: who’s to be alerted the cardiologist or the cardiac surgeon? J Cardiothorac Surg 2009; 4: 54. [CrossRef]
  • Larson EW, Edwards WD. Risk factors for aortic dissection: a necropsy study of 161 cases. Am J Cardiol 1984; 53: 849-55. [CrossRef]
  • Reed D, Reed C, Stemmermann G, Hayashi T. Are aortic aneurysms caused by atherosclerosis? Circulation 1992; 85: 205-11. [CrossRef]
  • Vilacosta I, San Román JA, Ferreirós J, Aragoncillo P, Méndez R, Castillo JA, et al. Natural history and serial morphology of aortic intramural he- matoma: a novel variant of aortic dissection. Am Heart J 1997; 134: 495- 507. [CrossRef]
  • Nienaber CA, von Kodolitsch Y, Petersen B, Loose R, Helmchen U, Hav- erich A, et al. Intramural hemorrhage of the thoracic aorta. Diagnostic and therapeutic implications. Circulation 1995; 92: 1465-72. [CrossRef]
  • Saritas A, Günes H, Kandis H, Cıkman M, Candar M, Korkut S, et al. A Retrospectice Analysis of Patients Admitted to our Clinic with Aortic Dissection. JAEM 2011; 10: 152-5.
  • Ledbetter S, Stuk JL, Kaufman JA. Helical (spiral) CT in the evaluation of emergent thoracic aortic syndromes. Traumatic aortic rupture, aortic aneurysm, aortic dissection, intramural hematoma, and penetrating atherosclerotic ulcer. Radiol Clin North Am 1999; 37: 575-89. [CrossRef]
  • Yüksel A, Erdur B, Türkçüer İ, Aydın B, Canbora PT. Acil Serviste Rüptüre Olmamış Aort Anevrizma ve Diseksiyonlarının Değerlendirilmesi: Olgu Serisi. JAEM 2008; 2: 17-20.
  • Yamada T, Shimpei T, Harada J. Aortic dissection without intimal rup- ture: diagnosis with MR imaging and CT. Radiology 1988; 2: 347-52.
  • Fabian TC, Davis KA, Gavant ML, Croce MA, Melton SM, Patton JH Jr, et al. Prospective study of blunt aortic injury: helical CT is diagnostic and antihypertensive therapy reduces rupture. Ann Surg 1998; 227: 666-77. [CrossRef]
  • Hirose H, Gill IS, Malangoni MA. Nonoperative management of trau- matic aortic injury. J Trauma 2006; 60: 597-601. [CrossRef]
  • Holmes JH 4th, Bloch RD, Hall RA, Carter YM, Karmy-Jones RC. Natural history of traumatic rupture of the thoracic aorta managed nonop- eratively: a longitudinal analysis. Ann Thorac Surg 2002; 73: 1149-54. [CrossRef]
  • Kepros J, Angood P, Jaffe CC, Rabinovici R. Aortic intimal injuries from blunt trauma: resolution profile in nonoperative management. J Trau- ma 2002; 52: 475-8. [CrossRef]
  • Motoyoshi N, Moizumi Y, Komatsu T, Tabayashi K. Intramural hemato- ma and dissection involving ascending aorta: the clinical features and prognosis. Eur J Cardiothorac Surg 2003; 24: 237-42. [CrossRef]

Traumatic Aortic Intramural Hematoma

Year 2013, Volume: 4 Issue: 1, 19 - 21, 01.01.2013

Abstract

Blunt traumatic aortic injury is a life threatening condition with a mortality rate of 30%. Aortic injury commonly involves the thoracic aorta with pseudoaneurysm and intramural hematoma. Aortic intramural hematoma is a dissection without an intimal tear. Intramural aortic hematoma is an uncommon but potentially lethal aortic disease. TEE, CT, MRI and Multidetector CT can ensure a rapid and accurate diagnosis of intramural hematoma. Management of traumatic aortic intramural hematoma is not well defined in the literature. Significant intramural aortic hematoma in stable patients may remain stable on follow-up imaging. In this study we present a traumatic aortic intramural hematoma which resolved with conservative treatment in a 36 year old man who fell from a height

References

  • Fabian TC, Richardson JD, Croce MA, Smith JS Jr, Rodman G Jr, Kearney PA, et al. Prospective study of blunt aortic injury: Multicenter Trial of the American Association for the Surgery of Trauma. J Trauma 1997; 42: 374-803. [CrossRef]
  • Aladham F, Sundaram B, Williams DM, Quint LE. Traumatic aortic injury: computerized tomographic findings at presentation and after conser- vative therapy. J Comput Assist Tomogr 2010; 34: 388-94. [CrossRef]
  • Kocoogullari CU, Emmiler M, Saglam H, Yavuz Y, Yurumez Y, Cekirdekci A. Infrarenal Abdominal Aortic Pseudoaneurysm in a Case with Abdomi- nal Aortic Atheromatous Plaque after Blunt Trauma: A Case Report and Review of the Literature. JAEM 2009; 8: 56-9.
  • Krukenberg E. Beitrage zur Frage des Aneurysma dissecans. Beitr Pathol Anat Allg Pathol 1920; 67: 329-51.
  • Baikoussis NG, Apostolakis EE, Siminelakis SN, Papadopoulos GS, Goudevenos J. Intramural haematoma of the thoracic aorta: who’s to be alerted the cardiologist or the cardiac surgeon? J Cardiothorac Surg 2009; 4: 54. [CrossRef]
  • Larson EW, Edwards WD. Risk factors for aortic dissection: a necropsy study of 161 cases. Am J Cardiol 1984; 53: 849-55. [CrossRef]
  • Reed D, Reed C, Stemmermann G, Hayashi T. Are aortic aneurysms caused by atherosclerosis? Circulation 1992; 85: 205-11. [CrossRef]
  • Vilacosta I, San Román JA, Ferreirós J, Aragoncillo P, Méndez R, Castillo JA, et al. Natural history and serial morphology of aortic intramural he- matoma: a novel variant of aortic dissection. Am Heart J 1997; 134: 495- 507. [CrossRef]
  • Nienaber CA, von Kodolitsch Y, Petersen B, Loose R, Helmchen U, Hav- erich A, et al. Intramural hemorrhage of the thoracic aorta. Diagnostic and therapeutic implications. Circulation 1995; 92: 1465-72. [CrossRef]
  • Saritas A, Günes H, Kandis H, Cıkman M, Candar M, Korkut S, et al. A Retrospectice Analysis of Patients Admitted to our Clinic with Aortic Dissection. JAEM 2011; 10: 152-5.
  • Ledbetter S, Stuk JL, Kaufman JA. Helical (spiral) CT in the evaluation of emergent thoracic aortic syndromes. Traumatic aortic rupture, aortic aneurysm, aortic dissection, intramural hematoma, and penetrating atherosclerotic ulcer. Radiol Clin North Am 1999; 37: 575-89. [CrossRef]
  • Yüksel A, Erdur B, Türkçüer İ, Aydın B, Canbora PT. Acil Serviste Rüptüre Olmamış Aort Anevrizma ve Diseksiyonlarının Değerlendirilmesi: Olgu Serisi. JAEM 2008; 2: 17-20.
  • Yamada T, Shimpei T, Harada J. Aortic dissection without intimal rup- ture: diagnosis with MR imaging and CT. Radiology 1988; 2: 347-52.
  • Fabian TC, Davis KA, Gavant ML, Croce MA, Melton SM, Patton JH Jr, et al. Prospective study of blunt aortic injury: helical CT is diagnostic and antihypertensive therapy reduces rupture. Ann Surg 1998; 227: 666-77. [CrossRef]
  • Hirose H, Gill IS, Malangoni MA. Nonoperative management of trau- matic aortic injury. J Trauma 2006; 60: 597-601. [CrossRef]
  • Holmes JH 4th, Bloch RD, Hall RA, Carter YM, Karmy-Jones RC. Natural history of traumatic rupture of the thoracic aorta managed nonop- eratively: a longitudinal analysis. Ann Thorac Surg 2002; 73: 1149-54. [CrossRef]
  • Kepros J, Angood P, Jaffe CC, Rabinovici R. Aortic intimal injuries from blunt trauma: resolution profile in nonoperative management. J Trau- ma 2002; 52: 475-8. [CrossRef]
  • Motoyoshi N, Moizumi Y, Komatsu T, Tabayashi K. Intramural hemato- ma and dissection involving ascending aorta: the clinical features and prognosis. Eur J Cardiothorac Surg 2003; 24: 237-42. [CrossRef]
There are 18 citations in total.

Details

Other ID JA29PD55EE
Journal Section Case Report
Authors

Mehmet Özgür Erdoğan This is me

Emine Gaffari This is me

Ahmet Şenel This is me

Türker Karaboğa This is me

Seçil Telli Erdoğan This is me

Publication Date January 1, 2013
Submission Date January 1, 2013
Published in Issue Year 2013 Volume: 4 Issue: 1

Cite

APA Erdoğan, M. Ö., Gaffari, E., Şenel, A., Karaboğa, T., et al. (2013). Traumatic Aortic Intramural Hematoma. Journal of Emergency Medicine Case Reports, 4(1), 19-21.
AMA Erdoğan MÖ, Gaffari E, Şenel A, Karaboğa T, Erdoğan ST. Traumatic Aortic Intramural Hematoma. Journal of Emergency Medicine Case Reports. January 2013;4(1):19-21.
Chicago Erdoğan, Mehmet Özgür, Emine Gaffari, Ahmet Şenel, Türker Karaboğa, and Seçil Telli Erdoğan. “Traumatic Aortic Intramural Hematoma”. Journal of Emergency Medicine Case Reports 4, no. 1 (January 2013): 19-21.
EndNote Erdoğan MÖ, Gaffari E, Şenel A, Karaboğa T, Erdoğan ST (January 1, 2013) Traumatic Aortic Intramural Hematoma. Journal of Emergency Medicine Case Reports 4 1 19–21.
IEEE M. Ö. Erdoğan, E. Gaffari, A. Şenel, T. Karaboğa, and S. T. Erdoğan, “Traumatic Aortic Intramural Hematoma”, Journal of Emergency Medicine Case Reports, vol. 4, no. 1, pp. 19–21, 2013.
ISNAD Erdoğan, Mehmet Özgür et al. “Traumatic Aortic Intramural Hematoma”. Journal of Emergency Medicine Case Reports 4/1 (January 2013), 19-21.
JAMA Erdoğan MÖ, Gaffari E, Şenel A, Karaboğa T, Erdoğan ST. Traumatic Aortic Intramural Hematoma. Journal of Emergency Medicine Case Reports. 2013;4:19–21.
MLA Erdoğan, Mehmet Özgür et al. “Traumatic Aortic Intramural Hematoma”. Journal of Emergency Medicine Case Reports, vol. 4, no. 1, 2013, pp. 19-21.
Vancouver Erdoğan MÖ, Gaffari E, Şenel A, Karaboğa T, Erdoğan ST. Traumatic Aortic Intramural Hematoma. Journal of Emergency Medicine Case Reports. 2013;4(1):19-21.