Aortic rupture is the breakage of all walls of the aorta, the largest artery in the body. Aortic rupture is a rare, extremely dangerous condition that is considered a medical emergency.[1] The most common cause is an abdominal aortic aneurysm that has ruptured spontaneously. Aortic rupture is distinct from aortic dissection, which is a tear through the inner wall of the aorta that can block the flow of blood through the aorta to the heart or abdominal organs.
| Aortic rupture | |
|---|---|
 | |
| Aorta segments, with thoracic aorta in area marked in green. | |
| Specialty | Vascular surgery, cardiology, emergency medicine |
| Symptoms | Abdominal pain, flank pain, or back pain |
| Complications | Shock, anemia |
| Usual onset | Acute |
| Causes | Ruptured aortic aneurysm, trauma |
| Treatment | Surgical repair |
| Prognosis | Poor |
| Deaths | Up to 90% of cases |
An aortic rupture can be classified according to its cause into one of the following main types:
- Traumatic aortic rupture
- Aortic rupture secondary to an aortic aneurysm[2]
Signs and symptoms
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Causes
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Mechanism
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Diagnosis
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Diagnosis of a ruptured abdominal aortic aneurysm (rAAA) is challenging, with a wrong diagnosis occurring in between 32 and 42 % of cases. Such errors further increase the mortality risk due to incorrect first response and treatment. In cases of misdiagnosis, aortic rupture is often mistaken for ureteric colic and myocardial infarction (MI).[3]
Differential diagnosis
editThe primary differential diagnoses include cardiogenic shock, pleural effusion, pulmonary embolism, myocarditis, myocardial infarction,[4] but may also encompass acute gastritis, appendicitis, diverticulitis, gallstones, peptic ulcer disease and urinary tract infection as well.[1]
Prevention
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Treatment
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Prognosis
editAn aortic rupture is a catastrophic medical emergency. People rarely survive such an injury. Mortality from aortic rupture is up to 90%. 65–75% of patients die before they arrive at the hospital and up to 90% die before they reach the operating room.[5]
References
edit- ^ a b Jeanmonod, Donald; Yelamanchili, Varun S.; Jeanmonod, Rebecca (2024), "Abdominal Aortic Aneurysm Rupture", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 29083705, retrieved 2024-10-25
- ^ Ruptured Aortic Aneurysm at Patient UK. Original Author: Laurence Knott. Current Version: Gurvinder Rull. Peer Reviewer: Hannah Gronow. Last Checked: 16/05/2012
- ^ Azhar, Bilal; Patel, Shaneel R.; Holt, Peter J.E.; Hinchliffe, Robert J.; Thompson, Matt M.; Karthikesalingam, Alan (August 2014). "Misdiagnosis of Ruptured Abdominal Aortic Aneurysm: Systematic Review and Meta-Analysis". Journal of Endovascular Therapy. 21 (4): 568–575. doi:10.1583/13-4626MR.1. ISSN 1526-6028. PMID 25101588.
- ^ "Aortic Dissection Differential Diagnoses". emedicine.medscape.com. Retrieved 2024-10-25.
- ^ Brown, LC; Powell, JT (September 1999). "Risk factors for aneurysm rupture in patients kept under ultrasound surveillance. UK Small Aneurysm Trial Participants". Annals of Surgery. 230 (3): 289–96, discussion 296-7. doi:10.1097/00000658-199909000-00002. PMC 1420874. PMID 10493476.