Occult Aortic Rupture Related to Blunt Thoracic Trauma

Introduction Blunt aortic trauma is an infrequent but not rare pathological entity. World Health Organization case reports indicate that the thoracic trauma is responsible for 25% of deaths caused by traumatic thoracic injury, second only to head trauma. Currently there are protocols on the investigation of patients who has sustained blunt thoracic injury and are unstable or have significant findings in the chest radiographs. However there are no clear guidelines on the investigation and management for a subgroup of patients who have sustained blunt thoracic trauma and are stable with no chest radiograph findings. Signs and symptoms in are blunt thoracic injury are unreliable and can be obscured by other injuries that are more apparent. This poses a challenge for any practicing emergency physician. This task is further complicated when, a patient, after a blunt injury to the chest, appears well and has minimal complaints. The following is such a case with aortic injury that was missed initially but, fortunately, the patient had a good outcome. It sparked a literature search for current evidence in the initial diagnostic modalities and algorithm in the management of patients with stable blunt traumatic chest injuries.