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July 22, 1974

Traumatic Aortic Rupture

Author Affiliations

From the Department of Radiology, University of Cincinnati Medical Center, Cincinnati.

JAMA. 1974;229(4):463-464. doi:10.1001/jama.1974.03230420075037

Diagnosis:  Traumatic aortic rupture.The chest roentgenogram on admission (Fig 1) shows enlargement of the aortic knob, widened mediastinum, and density along the descending aorta. There is a small pneumothorax on the right and bilateral juxtahilar alveolar infiltration characteristic of pulmonary contusion.A chest tube was inserted into the right pleural cavity. After this, a thoracic aortogram was performed through a transfemoral approach (Fig 2). The aortogram shows an irregularity of the aortic margin just beyond the left subclavian artery, representing the site of aortic tear. Immediately distal to this, an elongated false aneurysm filled with contrast medium terminates inferiorly where the aorta resumes its normal caliber. There is a residual right pneumothorax and fluid in the left pleura, probably blood.At operation, a complete tear of the aorta was found, with almost 3 cm of separation between the torn ends. The false aneurysm was walled off by organized blood