Endovascular Management of Aortic Rupture Secondary to Thoracolumbar Spine Fracture From a Domestic Fall: A Case Report and Clinical Challenges.
David Pakeliani, Liborio Ferrante, Giuseppe Indelicato et al.
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Case in brief
A 71-year-old woman sustained a thoracolumbar spine fracture and posterior aortic rupture at the level of the celiac trunk after an accidental fall at home. Hemorrhagic shock and severe hemodynamic instability led to percutaneous endovascular management, using REBOA for stabilization followed by a parallel-graft sandwich configuration. After clinical stabilization, thoracolumbar spinal fixation was performed in a staged manner.
What made this case unusual
The aortic rupture accompanied a spine fracture after a domestic fall, rather than the high-speed collisions or falls from height more commonly described in this injury combination.
Diagnostic / clinical pearl
In combined aortic and thoracolumbar injuries with hemodynamic instability, endovascular control may permit stabilization before staged spinal fixation; multidisciplinary planning is central to the approach described.