흉부 외상 환자에서 경식도 심초음파에 의한 대동맥 손상 진단의 유용성

Background: Early recognition of thoracic aortic disease is critical to reduce morbidity and mortality. The accuracy and safety of TEE in trauma patients has recently challenged to traditional diagnostic modality for assessing thoracic aortic disease such as computed tomogram (CT) scan, aortography, and magnetic resonance imaging (MRI). The purpose of this study was to evaluate the utility of TEE as an emergency diagnostic procedure for detection of thoracic aortic injury in trauma patients.<BR> Methods: From March 1998 to October 2002, 21 traumatic patients who had a suspicious of thoracic aortic injury and underwent TEE as the first diagnostic tool in the emergency department were enrolled. Indications of TEE in the suspicious thoracic aortic disease were typical chest pain, mediastinal widening or massive left side hemothorax.<BR> Results: There was no complication during TEE or post procedure of TEE in all patients. The findings of TEE were as followings: aortic dissection was 9 cases (43%), periaortic hematoma was 5 cases (24%), and aortic rupture, aneurysm, intramural hematoma, RA rupture, cardiac tamponade, and both hemothorax was 1 case in each other. The open thoracotomy on 11 patients were performed and emergency department thoracotomy on 2 patients were performed. Ten patients were performed conservative management.<BR> Conclusion: We suggest that TEE is a useful and safe diagnostic modality to detect thoracic aortic injury in hemodynamically unstable patient after trauma.