CTICasesTraumatic Aortic Pseudoaneurysm
Imaging findings
Chest radiograph shows a widened mediastinum. Contrast-enhanced CT demonstrates a traumatic pseudoaneurysm at the aortic isthmus with an adjacent mediastinal hematoma. An intramural hematoma extends from the isthmus down the descending thoracic and abdominal aorta to the aortic bifurcation. Thoracic spine fractures are also present.
Key takeaways
Traumatic aortic injury typically occurs at the aortic isthmus due to rapid deceleration. It can present as an intimal tear, pseudoaneurysm, or free rupture. An associated intramural hematoma can extend along the length of the aorta. Urgent endovascular repair (TEVAR) is the standard treatment for pseudoaneurysms to prevent rupture.
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