A 59-year-old man was involved in a head-on automobile accident. When seen in the emergency department, he was in hypovolemic shock and showed signs of extensive bruising on the lower part of the anterior abdominal wall. He was wearing a seat belt at the time of the accident. On examination, his abdomen was distended and tense; he had hypotension and tachycardia. A diagnosis of ruptured abdominal aorta was made during an emergency laparotomy. In cases of blunt traumatic injury to the abdominal aorta, do all patients become hypotensive immediately? Explain the possible role that the kidneys may play in causing damage to the aorta in deceleration injuries.

Question

Quizplus · Accepted Answer

The Answer is Frequently, patients with blunt rupture to the abdominal aorta may not immediately show signs of hypovolemic shock because the aorta is situated behind the peritoneum in the retroperitoneal space and the blood may not escape immediately into the peritoneal cavity (see text Fig. 5-62).
On impact, the patient may be held stationary by the seat belt, but the kidneys may continue forward until restrained by the vascular pedicles. Avulsion of the renal artery from the side of the aorta may take place under these circumstances.

A 59-Year-Old Man Was Involved in a Head-On Automobile Accident