Linuma et al. (2006)[3] |
39/M |
N/S |
Crush injury |
Severe epigastric pain, severe abdominal tenderness, elevation of WBC, LFT, LDH |
Extravasation from a minor tear of CA |
None |
Surgical ligation |
D/C at POD #16 |
Kirchhoff et al. (2007)[4] |
66/M |
N/S |
MVA |
Liver failure (PID #6) |
CA flap with wall hematoma CA-CHA thrombosis, liver necrosis |
TBI, MRF, bilateral HPTx |
None |
Death d/t fulminant hepatic failure (HOD #7) |
Suchak et al. (2007) [5] |
41/M |
Hypertension |
MVA - rollover |
Severe epigastric pain (PID #2) |
Intimal flap in proximal CA |
Muscle contusion |
Endovascular self-expandable stent |
Symptom resolved after stent |
Gorra et al. (2009) [6] |
29/M |
N/S |
Fall (9 m) |
Midback pain, mild LFT elevation |
CA dissection with periarterial stranding |
Humerus Fx., pelvic Fx., pulmonary contusion |
Anticoagulation (heparin → warfarin) 3 Mo |
f/u CT (3 Mo) : complete occlusion of CA with collateral flow to branches |
Laeseke and Gayer (2012) [7] |
47/M |
N/S |
Motorcycle TA (abdomen hit by handle bar) |
Mild epigastric, LUQ pain, feeling of distension, nausea elevation of LFT, lipase |
Intimal injury and focal thrombus involving distal CA, proximal CHA, SA |
None |
Aspirin 81 mg |
Lost to f/u |
Sarkar et al. (2012) [8] |
26/M |
N/S |
MVA - ejected from vehicle |
No symptoms |
Focal dissection near origin of CA |
Open tibia fibula Fx., MRF, L1-L3 TP Fx. |
Anticoagulation (enoxaparin → warfarin) 3 Mo |
f/u CT (3 Mo): complete resolution of dissection |
Rosenthal et al. (2015) [9] |
26/M |
N/S |
Fall (46 m) into a river |
No symptoms, LFT elevation |
85% stenosis of CA, Dissection 7 mm from CA origin Adjacent soft tissue stranding |
PTx, hemurus Fx., T4, T5 Fx., talus Fx., MRF |
Aspirin 81 mg |
f/u CT (1 week) : persistent CA dissection, moderate stenosis |
Present case 1 |
68/M |
Old age |
Bicycle TA -with a motorcycle |
Epigastric pain mild elevation of LFT, LDH |
Focal intimal flap : 1 cm distal to CA origin to trifurcation |
MRF, L2-3 TP Fx. |
Aspirin 100 mg, 3 Mo |
D/C at HOD #6, symptom free for 18 Mo |
Present case 2 |
49/M |
Mild atherosclerosis on CT |
Motorcycle TA |
Epigastric pain radiating to left back (PID #8) |
CA dissection with focal thrombus Narrowing of CHA and SA with perivascular soft tissue stranding |
Thigh contusion |
Anticoagulation (heparin, 3 days) → aspirin 100 mg 3 Mo |
D/C at HOD #4 symptom-free for 1 Mo |