Trauma of the Aorta

Abstract

Traumatic aortic injury is a major cause of lethal injury in the trauma population. Those patients that do survive the injury are at high risk of mortality. The severity of the injury was recognized in the literature over 60 years ago, and significant advancements in diagnosis and management have been made. The pathophysiology of the injury is not clearly understood, but many models have been purported and tested. Patients with this injury do not present with discrete injuries. Rather they present with a complex variation of injuries oftentimes in extremis. It is the mechanism of injury and the pattern of injury that must tip the astute trauma team to investigate for this lethal injury in the wake of a dizzying array of associated serious injuries. The use of computed tomography has propelled the recognition of traumatic aortic lesions including ones that would have previously been untreated. Enhanced understanding of the natural history of traumatic aortic lesions has led to the development of improvements in surgical treatments and conservative management without surgery.