Aortic Injury on CT

The previous blog posts http://cookcountytrauma.blogspot.com/2011/09/blunt-aortic-injury-work-up.html and http://cookcountytrauma.blogspot.com/2011/09/blunt-aortic-injury-diagnosis-and.html contained some old pictures of Aortic injury.

We recently had a patient with aortic injury and some classic images:

Here is his upright CXR - his mediastinum is not markedly wide, and his mediastinal/chest width ratio is 0.33, but the aortic knob is blurred, suggesting a peri-aortic hematoma.





Note the "mushroom cap" appearance of his proximal descending aorta on this axial CT. 

The pseudoaneurysm is easily seen on this coronal CT.  This is the most common location of Traumatic Aortic Rupture - just distal to the left subclavian.

Of note: intraoperative finding confirmed the injury and was noted to be 90% transected.