Traumatic pseudoaneurysm of the aortic arch with aortovenous fistula

摘要

An 18-year-old female was stabbed in the chest and presented to a peripheral hospital with an entry wound over the left stemoclavicular joint. Contrast enhanced computed tomography (CT) of the chest (Fig. 1A, coronal; Fig. 1B, sagittal; and Fig. 1C, three-dimensional reconstruction of CT aortogram) showed contained mediastinal hematoma (MH) and complex aortic pseudoaneurysm (APA) formation. Thoracic aortogram (Fig. 2) confirmed the presence of a pseudoaneurysm (APA) arising from the aortic arch (AA) with contrast seen filling the inominate vein (IV) and superior vena cava (SVC) indicating an aortovenous fistula. She was transferred for emergent surgery. Femoro-femoral cardiopulmonary bypass (CPB) was instituted prior to sternotomy.