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BLUNT AORTIC INJURY

Blunt aortic injuries are uncommon in patients surviving to hospital (1). 

Patients surviving to hospital with aortic laceration are more likely to have the bleeding tamponaded by surrounding structures creating a false aneurysm (2). Thoracic aortic lacerations may decompress into the hemithorax or the mediastinum causing catastrophic bleeding. Small intimal tears likely will not be seen with bedside US. 

 Aortic dissection due to blunt trauma typically occurs at the isthmus where the aortic arch becomes the descending aorta (3). 

Blunt aortic injuries are best visualised from the suprasternal (described in the cardiac section) or the abdominal views (described in the abdominal aorta section) of the aorta. 

Trans Mid Aorta: Aortic laceration with a contained haematoma in a patient with blunt abdominal injuries

Long Abdominal Aorta showing a false aneurysm anteriorly: contained laceration. Note: this is not a dissection flap. A dissection flap has undulating independent movement whereas this hyperechoic line moves in synchronicity with the aortic pulsations. 

AORTIC DISSECTION

Aortic dissection flap seen from the subxyphoid view

Abdominal Aorta Long showing a dissection flap extending above the epigastric aorta. Not the movement of the flap is independent to the aortic pulsation.

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