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  • Description:
  • At our trauma center, aortography has largely been replaced by helical CT scan of the mediastinum in the evaluation of the aorta in patients with a mechanism of injury suggestive of aortic abnormality, irrespective of findings on the initial chest radiography. As shown in the present series, one third of our patients with an aortic rupture did not have any mediastinal abnormality. In the group of patients with a widened mediastinum, CT evaluation may be useful in evaluating not only the aorta but also the spine. Spinal fractures may be the cause of a widened mediastinum. In our study, 21.4% of the 42 patients with a widened mediastinum had a spinal fracture (1 patient had both aortic and spinal injury). In another patient, the CT scan showed that the widened mediastinum on chest radiography was due to a sternal fracture with retrosternal hematoma. This patient avoided aortography (Figure 1). Persons involved in high-speed deceleration accidents almost always require CT evaluation of the head or abdomen. Addition of a chest CT scan prolongs the evaluation process by only a few minutes as compared with the time-consuming angiography.
  • License:
  • Rights Managed
  • Rights Holder:
  • JAMA
  • License Rights Holder:
  • Copyright 1998 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
  • Asset Type:
  • Image
  • Asset Subtype:
  • Illustration
  • Image Orientation:
  • Landscape
  • Image Dimensions:
  • 590 x 251
  • Image File Size:
  • 28.8 KB
  • Creator:
  • Demetrios Demetriades MD, Hugo Gomez MD, George C. Velmahos MD, Juan A. Asensio MD, James Murray MD, Edward E. Cornwell III MD, Kathleen Alo RN, Thomas V. Berne MD
  • Credit:
  • Demetriades, D., Gomez, H., Velmahos, G. C., Asensio, J. A., Murray, J., Cornwell III, E. E., Alo, K., & Berne, T. V. (1998). Routine Helical Computed Tomographic Evaluation of the Mediastinum in High-Risk Blunt Trauma Patients. Arch Surg, 133(10), 1084-1088. https://doi.org/10.1001/archsurg.133.10.1084.
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  • Keywords:
  • Restrictions:
  • Property Release:
  • No
  • Model Release:
  • No
  • Purchasable:
  • Yes
  • Sensitive Materials:
  • No
  • Article Authors:
  • Demetrios Demetriades MD, Hugo Gomez MD, George C. Velmahos MD, Juan A. Asensio MD, James Murray MD, Edward E. Cornwell III MD, Kathleen Alo RN, Thomas V. Berne MD
  • Article Copyright Year:
  • 1998
  • Publication Volume:
  • 133
  • Publication Issue:
  • 10
  • Publication Date:
  • 10/01/1998
  • DOI:
  • https://doi.org/10.1001/archsurg.133.10.1084

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