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首页> 外文期刊>Orthopedic reviews. >Traumatic Infra-renal Aortic Dissection After a High-energy Trauma: A Case Report of a Primary Missed Diagnosis
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Traumatic Infra-renal Aortic Dissection After a High-energy Trauma: A Case Report of a Primary Missed Diagnosis

机译：高能创伤后的创伤性肾下主动脉夹层：一例原发性漏诊的病例报告

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A traumatic infra-renal aortic dissection is a rare but life-threatening injury that follows deceleration injuries. The mechanism of blunt abdominal aortic injury involves both direct and indirect forces. The successful management of patients with traumatic injuries depends on a prompt suspicion of the injury and early diagnosis and therapy. Missed injuries in trauma patients are well-described phenomena and implementation of the ATLS? trauma schedule led to a decrease in the number of missed injuries, but trauma computed tomography (CT) scans in injured patients are still not standard. We report on a 54-year old Caucasian female patient who was involved in a car accident. The fellow passenger of the car was seriously injured. The patient had been previously treated at two different hospitals, and a dislocated acetabular fracture had been diagnosed. Because of this injury, the patient was transferred to our institution, a level 1 trauma-center where, according to the nature of the accident as a high-energy trauma, a complete polytrauma management was performed at the time of admission. During the body check, a moderate tension of the lower parts of the abdomen was detected. During the CT scan, an aneurysm of the infra-renal aorta with a dissection from the height of the second lumbar vertebral body to the iliac artery was observed. The patient required an operation on the day of admission. After 19 days post-trauma care the patient was able to leave our hospital in good general condition. Therefore, missed injuries in multiple injury patients could be fatal, and it is essential that the orthopedic surgeon leaves room for suspicion of injuries based on the nature of the trauma. Traumatic injuries of the abdominal aorta are rare. According to the ATLS? trauma schedule, all of the patients who have experienced high-energy trauma and associated fractures should undergo routine screening using a trauma CT scan with contrast agents to detect potential life-threatening injuries. In case of abdominal trauma, an aortic dissection, which can easily be overlooked, has to be considered.Key words: traumatic aortic dissection, missed injury, high-energy trauma, computed tomography scan
机译：创伤性肾下主动脉夹层是罕见的，但会在减速损伤后危及生命。腹部主动脉钝性损伤的机制涉及直接力和间接力。对创伤性损伤患者的成功治疗取决于对损伤的迅速怀疑以及早期诊断和治疗。创伤患者遗漏的伤害是描述良好的现象，并且实施ATLS吗？创伤时间表导致遗漏的受伤人数减少，但是受伤患者的创伤计算机断层扫描（CT）扫描仍不标准。我们报告了一名发生车祸的54岁白人女性患者。汽车的同行乘客受了重伤。该患者先前曾在两家不同的医院接受过治疗，并且已诊断出髋臼骨折脱位。由于这种伤害，患者被转移到我们的机构，这是一家1级创伤中心，根据该事故作为高能创伤的性质，在入院时进行了全面的多创伤治疗。在身体检查期间，检测到腹部下部中等程度的张力。在CT扫描期间，观察到了肾下主动脉的动脉瘤，并从第二个腰椎椎体的高度到artery动脉解剖了解剖。患者在入院当天需要手术。创伤治疗后19天，患者能够以良好的总体状况离开我们的医院。因此，多发伤患者的遗漏伤亡可能是致命的，并且骨科医师必须根据外伤的性质为怀疑受伤的余地留出空间。腹主动脉外伤很少见。根据ATLS？创伤时间表，所有经历过高能量创伤和相关骨折的患者均应使用创伤CT扫描和造影剂进行常规筛查，以发现可能危及生命的伤害。如果发生腹部外伤，必须考虑容易被忽视的主动脉夹层。

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