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Azygous Vein Rupture and Descending Aortic Intramural Hematoma after Blunt Thoracic Trauma

Abstract

Vassileios Drosos1, Nicole Rickert2, Anne Marie Augustin2, Annette Thurner2, Dejan Radakovic1 and Ivan Aleksic1*

Most injuries to thoracic great vessels are caused by penetrating trauma but can occur after blunt trauma as well. Combined injury of azygous vein and descending thoracic aorta is rare. A 56 year-old woman suffered a motor vehicle accident. Computed Tomography (CT) revealed rupture of the azygous vein with bilateral serial rib fractures. The azygous vein was suture ligated. Repeat CT showed new intramural hematoma of the descending aorta causing compression of the celiac trunc. A Terumo Relay® aortic stent was implanted transfemorally. Early repeat CT can detect additional vascular injuries after major thoracic trauma and allows for combined open and endovascular management of such injuries.

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