Subintimal Aortic Dissection With Occlusion After Blunt Abdominal Trauma

Abstract

Although blunt trauma to the abdomen has long been a subject of interest to surgeons experienced in both war and civilian accidents, much attention has recently been focused on such injuries relative to automotive vehicular accidents. Abdominal wall contusions, abrasions, and hematomata now immediately arouse suspicion of intra-abdominal and pelvic visceral injury, especially when the victim has been wearing a seat belt. However, little has been written about disruption or occlusion of the abdominal aorta and its main branches as a complication of blunt abdominal trauma due to sudden deceleration with or without the use of a seat belt. Acute traumatic disruption of the thoracic aorta secondary to rapid deceleration is by no means rare and has been lucidly described by Beal et al in a recent review.¹ Similar injuries to the abdominal aorta are considerably less frequent. Furthermore, among the types of aortic injuries incurred, traumatic subintimal dissection