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. 2015:10:76-9.
doi: 10.1016/j.ijscr.2015.03.027. Epub 2015 Mar 20.

Aortic dissection associated with blunt chest trauma diagnosed by elevated D-dimer

Joshua L Penn  1 , Jennfier L Martindale  1 , Leslie W Milne  2 , Keith A Marill  3
Affiliations

Aortic dissection associated with blunt chest trauma diagnosed by elevated D-dimer

Joshua L Penn et al. Int J Surg Case Rep. 2015.

Abstract

Introduction: Similar to spontaneous aortic dissection, traumatic aortic dissection is diagnosed with a careful history and physical exam, chest radiograph, and ultimately, dedicated aortic imaging. The diagnosis of spontaneous aortic dissection may be aided by using the serum D-dimer test. The use of D-dimer for diagnosing aortic injury in the setting of blunt trauma has not previously been reported.

Presentation of case: We present a case of aortic dissection in a 61-year-old male diagnosed when the patient presented with chest pain after blunt chest trauma.

Discussion: The patient had no known history or risk factors for aortic disease. None of the classic findings were present by history, physical examination or chest radiograph and the diagnosis was made as the result of an elevated D-dimer. We discuss how the D-dimer test fortuitously led to the diagnosis in this case, and the implications.

Conclusion: D-dimer could be helpful in diagnosing aortic injuries in low-risk chest trauma patients.

Keywords: Aortic dissection; Bovine-type aortic arch; Chest trauma; D-dimer.

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Figures

Fig. 1
Fig. 1
Postero-anterior (PA) chest X-ray.
Fig. 2
Fig. 2
(A) CT slice of aortic arch with evidence of dissection flap. (B) Reconstructed coronal CT image of the chest with evidence of extensive antegrade extension of the aortic dissection.
See this image and copyright information in PMC

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