Classification There are inconsistencies in the terminology of<unk> c<unk> . There are several terms which are interchangeably used to describe<unk>  to the<unk>  such as tear, laceration, transection, and rupture. Laceration is used as a term for the consequence of a tear, whereas a transection is a section across an axis or cross section. For all intents and purposes, the latter is used when a tear occurs across all or nearly all of the circumference of the<unk> . Rupture is defined as a forcible disruption of tissue. Some disagree with the usage of rupture as they believe it implies that a tear is incompatible with life; however, the term accurately gauges the severity of tears in the<unk> . A rupture can be either complete or partial, and can be classified further by the position of the tear. Imaging The gold standard for diagnosis of<unk> <unk> c<unk>  is<unk> graphy. This method involves inserting a catheter into the<unk>  and directly injecting contrast material. The primary benefit of<unk> graphy is the ability to precisely determine the location of<unk>  for surgical planning. Another imaging modality is CT angiogram which has a sensitivity of 100%. A CT angiogram relies on timing the CT scan after a bolus of IV contrast is administered from a peripheral IV site. Since a CT angiogram has a sensitivity of 100% and less invasive due to the peripheral placement of the IV line than<unk> graphy it is the primary imaging choice. This allows visualization of the<unk>  and provides precise locations of traumatic<unk> . A CT angiogram does show both direct and indirect signs of<unk> c<unk> . The indirect sign that you can see is effacement of fat due to a hematoma. This sign should clue in a radiologist that there is an underlying<unk> . Some direct signs from a CT include having an intimal flap, irregularity of the shape of the<unk> , filling defects secondary to a thrombus, or out pouching of the<unk> . However, non contrasted CT scans, chest X-rays, and transesophageal echos can also be used. Chest X-rays most sensitive finding is a widened mediastinum of greater than 8 cm. An apical cap and displacement of the trachea to either side of the chest from midline can also be seen. A normal chest X-ray, however, does not exclude a diagnosis of<unk> <unk> c<unk> . A chest X-ray can also be useful to diagnose subsequent problems caused by<unk> c rupture such as pneumothorax or hemothorax. Non contrasted CT scans might show an intimal flap, periaortic hematoma, luminal filling defect,<unk> c contour abnormality, pseudoaneurysm, contained rupture, vessel wall disruption, active extravasation of intravenous contrast from the<unk>  and is therefore useful to assess for minimal<unk> c<unk> . Trans esophageal echos are useful in patients that are hemodynamically unstable, but the sensitivity and specificity of this study varies based on clinical user. The trans esophageal echo relies on placement an ultrasound probe into the patient's esophagus in order to get an ultrasound of the heart. If esophageal<unk>  is expected, the patient has a facial<unk> , or if the patient has difficulty maintaining their away then the trans esophageal echo is contraindicated.
Thoracic aorta injury
Traumatic aortic rupture
Diaphragmatic rupture
Esophageal rupture
Pulmonary contusion
Right heart strain
Pulmonary laceration
Pulmonary hematoma