PubMed · 9047896
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A Koike, M Ito, I Yasuda, K Yamaguchi, E Takeuchi. 1996. [Pseudoaneurysm].. https://pubmed.ncbi.nlm.nih.gov/9047896/
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Report of a case of a mycotic pseudoaneurysm of the ascending thoracic aorta occurring in the absence of surgical or blunt trauma in a patient who presented with purulent pericarditis. Surgical pericardial drainage was required, which revealed Staphlococcal aureus. Subsequent transesophageal echocardiogram demonstrated a 4 cm x 4 cm pseudoaneurysm of the posterior wall of the aorta above the sinotubular junction. The patient refused surgical correction of the aortic pseudoaneurysm and was successfully managed with antibiotic therapy.
A 69-year-old diabetic male with salmonella bacteremia developed hypovolemic shock and swelling of the neck. A CT examination revealed massive mediastinal hemorrhage extending into the neck soft tissues caused by false aneurysm rupture of the descending thoracic aorta. Aortography showed continuous extravasation from a large leak at the medial side of the descending thoracic aorta. Although surgical intervention was immediately performed, the patient died 3 weeks later from multiple-organ failure. In this report, CT and angiographic findings of mycotic aneurysm rupture are presented and a review is given.
Penetrating injuries to the abdominal aorta most often result in rapid exsanguination and death. Immediate surgical intervention may result in control of hemorrhage and survival of the patient. Rarely, hemorrhage after aortic injury may be contained by surrounding tissues, resulting in pseudoaneurysm formation. Traumatic pseudoaneurysms may rupture at any time, and this is usually a fatal event. A 47-year-old man recently presented with a supraceliac abdominal aortic pseudoaneurysm that ruptured into the right chest 28 years after a gunshot wound to the back. This report describes the pathophysiology, diagnosis, and treatment of traumatic pseudoaneurysms of the abdominal aorta and includes a review of the literature. This is a case in which a traumatic pseudoaneurysm of the abdominal aorta was successfully repaired by surgery after rupture into the thorax and is the first such case to be reported in the literature.