Aortic isthmus transection with pseudoaneurysm on CT in a resource-limited country: management challenges and fatal outcome

A case of blunt thoracic aortic injury with full-thickness transection 2.5 cm distal to left subclavian artery, pseudoaneurysm, and mediastinal hematoma highlights the lethal impact of imaging/referral delays in resource-limited settings—patient died 12h post-injury.

• Contrast-enhanced CT showed a full-thickness aortic transection 2.5 cm distal to the left subclavian artery with a pseudoaneurysm and massive mediastinal hematoma.
• Despite aggressive resuscitation and attempted transfer, the patient died 12 hours after injury, underscoring the critical need for timely access to vascular surgery.
• Delays in imaging, referral, and definitive repair in resource-limited settings significantly reduce survival in otherwise potentially salvageable aortic injuries.

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