Aortic rupture - Misplaced Pages

Breakage of the aorta Not to be confused with aortic dissection. Medical condition

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

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. 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.

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

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).

Differential diagnosis

The primary differential diagnoses include cardiogenic shock, pleural effusion, pulmonary embolism, myocarditis, myocardial infarction, but may also encompass acute gastritis, appendicitis, diverticulitis, gallstones, peptic ulcer disease and urinary tract infection as well.

Prevention

Further information: Aortic aneurysms § Prevention

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Treatment

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Prognosis

An 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.

References

^ 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.

Cardiovascular disease (vessels)

Arteries, arterioles
and capillaries

Inflammation	Arteritis Aortitis Buerger's disease
Arteriosclerosis	Atherosclerosis Foam cell Fatty streak Atheroma Cholesterol LDL Oxycholesterol Trans fat Monckeberg's arteriosclerosis Hyaline arteriolosclerosis Hyperplastic arteriolosclerosis
Peripheral artery disease	Stenosis Carotid artery stenosis Renal artery stenosis Aortoiliac occlusive disease Critical limb ischemia Degos disease Erythromelalgia Fibromuscular dysplasia Hepatic artery thrombosis Intermittent claudication Raynaud's phenomenon
Aneurysm / dissection / pseudoaneurysm	torso: Aortic aneurysm Abdominal aortic aneurysm Thoracic aortic aneurysm Aneurysm of sinus of Valsalva Aortic dissection Aortic rupture Coronary artery aneurysm head / neck Intracranial aneurysm Intracranial berry aneurysm Carotid artery dissection Vertebral artery dissection Familial aortic dissection
Vascular malformation	Arteriovenous fistula Arteriovenous malformation Telangiectasia Hereditary hemorrhagic telangiectasia Generalized essential telangiectasia
Vascular nevus	Cherry hemangioma Halo nevus Spider angioma

Veins

Inflammation	Phlebitis
Venous thrombosis / Thrombophlebitis	primarily lower limb Deep vein thrombosis abdomen Hepatic veno-occlusive disease Budd–Chiari syndrome May–Thurner syndrome Portal vein thrombosis Renal vein thrombosis upper limb / torso Mondor's disease Paget–Schroetter disease Pulmonary embolism head Cerebral venous sinus thrombosis Post-thrombotic syndrome
Varicose veins	Gastric varices Portacaval anastomosis Caput medusae Esophageal varices Hemorrhoid Varicocele
Other	Chronic venous insufficiency Chronic cerebrospinal venous insufficiency Superior vena cava syndrome Inferior vena cava syndrome Venous ulcer

Arteries or veins

Blood pressure

Hypertension	Hypertensive heart disease Hypertensive emergency Hypertensive nephropathy Essential hypertension Secondary hypertension Renovascular hypertension Benign hypertension Pulmonary hypertension Systolic hypertension White coat hypertension
Hypotension	Orthostatic hypotension Shock (circulatory)

Category:

Diseases of the aorta