Periaortic hematoma on abdominal computed tomographic scanning as an indicator of thoracic aortic rupture in blunt trauma

• Published in: The journal of trauma Vol. 52; no. 4; p. 699
• Main Authors: Curry, James Dylan, Recine, Carl A, Snavely, Elizabeth, Orr, Marian, Fildes, John J
• Format: Journal Article
• Language: English
• Published: United States 01.04.2002
• Subjects: Aorta, Thoracic - injuries; Aortic Rupture - diagnostic imaging; Aortic Rupture - etiology; Hematoma - diagnostic imaging; Hematoma - etiology; Hemothorax - diagnostic imaging; Hemothorax - etiology; Humans; Image Processing, Computer-Assisted; Retrospective Studies; Sensitivity and Specificity; Tomography, X-Ray Computed; Wounds, Nonpenetrating - complications; Wounds, Nonpenetrating - diagnostic imaging
• ISSN: 0022-5282; 1529-8809
• DOI: 10.1097/00005373-200204000-00015

In our institution, we have noted an association between periaortic hematomas (PH) present on abdominal computed tomographic (CT) scans and patients with thoracic aortic rupture (TAR) in blunt trauma. This 5-year retrospective study determined the sensitivity and specificity of PH and left hemothorax seen on abdominal CT scan as an indicator of TAR. The trauma registry and records identified 54 blunt trauma patients who had a CT scan of the abdomen and an arch aortogram. Fourteen patients with TAR and 40 patients without TAR were selected for analysis. A digital photograph of an upper cut of the abdominal CT scan for each patient was examined by radiology staff for the presence or absence of PH and left hemothorax. The sensitivity, specificity, positive predictive value, and negative predictive value of PH as a predictor of TAR were 88%, 99%, 97%, and 96%, respectively. The finding of PH on CT scan of the abdomen in blunt trauma patients should alert the clinician to the high likelihood of thoracic aortic injury.