In Reply to: Re: Case 0298_11--Infrarenal abdominal aortic traumatic rupture: Treatment with endoluminal covered stent posted by Charles P. Semba on February 06, 1998 at 18:27:54:
It is unlikely that the injury was caused iatrogenically. When you cut the aorta with a scalple you know about it fairly dramatically. If you look at the morphology of the tear, it is rather irregular with both pseudoaneurysm and dissection in it. A knife injury would probably look a lot cleaner. We have encountered 3 cases in a similar position that looked almost identical. All patients had tremendous impact (MVA with severe casualties) and all had their seatbelts on. We suspect that this is a form of seatbelt injury affecting the abdominal aorta. The beauty of this case is the ability to fix it in less than an hour with a relatively small stent-graft requiring a 10F hole. You can almost do it as an outpatient procedure... Schneider is promissing to produce 14mm and 16mm wide Wallgrafts soon. They are also promissing to have them preloaded.