CTICasesTraumatic Partial Aortic Transection
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Imaging findings
Contrast-enhanced chest CT in a blunt trauma patient reveals mediastinal hematoma tracking to the subcarinal region, a left paraspinal line contour deformity, and a partial aortic transection just distal to the left subclavian artery origin at the aortic isthmus. Serial CT imaging over 24 hours shows a stable aortic contour and redistribution of mediastinal hematoma into simple pleural effusions.
Key takeaways
Traumatic aortic injury typically occurs at the aortic isthmus due to rapid deceleration. In patients with stable, non-ruptured partial aortic transections, current management standards often support a 'watch and wait' approach with blood pressure control, allowing clinical stabilization of more immediate life-threatening injuries (such as intracranial or intra-abdominal hemorrhage) prior to definitive endovascular stenting.
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