CTICasesPre-existing Intramural Aortic Blood Pool Mimicking Acute Traumatic Aortic Injury
Imaging findings
Contrast-enhanced CT angiogram in a blunt trauma patient demonstrates a stable, curvilinear pocket of contrast enhancement adjacent to the wall of the distal aortic arch, connecting to an intercostal or bronchial artery. Short-term follow-up CT shows no change in size or morphology of the collection.
Key takeaways
An aortic intramural blood pool is a chronic vascular finding associated with previous intramural hematoma or communicating intercostal/bronchial arteries. When encountered during a trauma workup, it must not be confused with acute traumatic aortic injury or active extravasation, especially when there is no surrounding mediastinal hematoma and the lesion is unchanged on short-term follow-up.
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