Periaortic hematoma on abdominal computed tomographic scanning as an indicator of thoracic aortic rupture in blunt trauma.

Background: In our institution, we have noted an association between periaortic hematomas (PH) present on abdominal computed tomographic (CT) scans and patients with thoracic aortic rupture (TAR) in blunt trauma. This 5-year retrospective study determined the sensitivity and specificity of PH and left hemothorax seen on abdominal CT scan as an indicator of TAR.

Methods: The trauma registry and records identified 54 blunt trauma patients who had a CT scan of the abdomen and an arch aortogram. Fourteen patients with TAR and 40 patients without TAR were selected for analysis. A digital photograph of an upper cut of the abdominal CT scan for each patient was examined by radiology staff for the presence or absence of PH and left hemothorax.

Results: The sensitivity, specificity, positive predictive value, and negative predictive value of PH as a predictor of TAR were 88%, 99%, 97%, and 96%, respectively.

Conclusion: The finding of PH on CT scan of the abdomen in blunt trauma patients should alert the clinician to the high likelihood of thoracic aortic injury.