The Significance of Chest Wall Injury in the Diagnosis of Traumatic Aneurysms of the Thoracic Aorta

Analytic Review: Blunt Chest Trauma: The Intensivist's Perspective

“…Such patients have a moderate degree of ventilation-perfusion inequality and intrapulmonary shunting, and their hypoxemia improves only slightly when supplementary oxygen is administered. Major teaching centers report treating 1 to 4 patients per year with this injury [32][33][34][35][36]. If intubation and respiratory support are not provided, their Pa02 continues to fall, and later their arterial carbon dioxide tension (PaC02) rises.…”

“…The chest roentgenogram is very useful as a screening procedure, but definitive diagnosis requires arch aortography [33][34][35][36][37]. The chest roentgenogram is very useful as a screening procedure, but definitive diagnosis requires arch aortography [33][34][35][36][37].…”

“…Less reliable associated findings not necessarily indicative of mediastinal hemorrhage include left hemothorax, fracture of the first or second rib, and clavicle fracture [35,40]. Of all the plain film ' findings, widening of the superior mediastinum is generally considered the most sensitive [35,40].…”

“…Of all the plain film ' findings, widening of the superior mediastinum is generally considered the most sensitive [35,40]. It is important to remember that these findings may be extremely subtle and, on occasion, may even be absent, especially if the film is taken very soon after the accident [35]. Therefore, the mechanism of injury must be considered and sound clinical judgment must be exercised in selecting patients for aortography.…”