Vai
Forum Elite
Topics: 30
Posts: 195
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sever deceleration injury with fracture of sternum, suspect Ao. rupture and order a chest x-ray:
- if on x-ray is a normal mediastinum, what to do next? spiral CT or transesophageal echography
- if on x-ray is a wide mediastinum, what to do next? aortography or TEE
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| chemamr
Moderator and PGY1
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Itīs a rupture of a thoracic aortic aneurysm, pbly the ascending aorta.
1) If chest X rays are normal, i guess there isnīt rupture, thus, a spiral CT is better. (Though the TEE is also good)
2) If rupture has occurred, a transesophageal echo is better. Though I think if rupture has occurred you should go immediately to the OR and try to save his/her life.
Edited by chemamr on 07/01/05 - 09:57 PM
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| Vai
Forum Elite
Topics: 30
Posts: 195
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i don't know the answer, i posted to clarify some discrepancy between different study materials
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| chemamr
Moderator and PGY1
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thatīs what I think according to what Iīve read. Iīll wait for other answers. 
Regards Vai !
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| bobby
Forum Guru
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in patient with a sospect of aortic rupture,
screening test = ct with contrast.
confirm with angiogram (aortography)
source: crush step 2.
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| rubyedward
Forum Elite
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what about TEE, when do we use it???
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| docrd24
Forum Newbie
Topics: 3
Posts: 35
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if on xray mediastinum is wide i.e rupture-------------AORTOGRAM
if mediastinum is normal---------------spiral ct
this is what kaplan says
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| chemamr
Moderator and PGY1
Topics: 703
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but if itīs ruptured, itīs a real life threatenig situation, you must go to the OR, donīt you? 
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