The Importance of the Mediastinal Triangle in Traumatic Lesions of the Aorta

Abstract

Background: Trauma-induced aortic injuries continue to be an important factor in morbimortality in patients with blunt trauma. Objectives: To determine the characteristics of aortic lesions in patients with closed thoracic trauma and associated thoracic injuries. Methods: Multicenter cohort study conducted during the years 1994 to 2014 in the radiology service in the University Hospital Complex of A Coruña. Patients >15 years with closed thoracic trauma were included. Sociodemographic and clinical variables were studied in order to determine the lesion cause, location, and degree. Results: We analyzed 232 patients with a mean age of 46.9 ± 18.7 years, consisting of 81.4% males. The most frequent location was at the level of the isthmus (55.2%). The most frequent causes of injury were traffic accidents followed by falls. Patients with aortic injury had more esophageal, airway, and cardiopericardial lesions. More than 85% of the patients had lung parenchyma and/or chest wall injury, which was more prevalent among those who did not have an aortic lesion. Conclusions: Patients with trauma due to traffic accidents or being run over presented three times more risk of aortic injury than from other causes. Those with an aortic lesion also had a higher frequency of cardiopericardial, airway, and esophageal lesions.

A case of mid-thoracic osteoporotic vertebral fracture with the inability to belch syndrome

“…The wedge kyphosis deformity of the mid-thoracic spine (i.e., T7 in this case) likely caused a localized minor narrowing of the esophagus, leading to air entrapment and making it difficult to belch [ Figure 4 ]. [ 1 , 3 , 6 ]…”

“…[ 3 , 6 ] Gastroesophageal reflux disease caused by osteoporotic vertebral fracture (OVF) occurs at the thoracolumbar junction around T12 levels. The inability to belch at the mediastinal triangle (asterisk)[ 1 ] caused by OVF occurs in the middle (T6,7) thoracic spine (Right).…”