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Late diagnosis of silent thoracic aortic rupture presented as a right pleural effusion.

Kanakis MA, Papavassiliou VG, Drosos P, Kaperonis EA, Benakis G, Lioulias AG - Case Rep Med (2012)

Bottom Line: Patients with ruptured thoracic aortic aneurysm rarely present in a stable clinical condition.A man was referred to our hospital with the diagnosis of ruptured saccular aneurysm of the descending thoracic aorta.He successfully underwent both endovascular graft repair and open thoracotomy.

View Article: PubMed Central - PubMed

Affiliation: Thoracic Surgery Department, Sismanoglio General Hospital, 1 Sismanogliou Street, Marousi, 151 26 Athens, Greece.

ABSTRACT
Patients with ruptured thoracic aortic aneurysm rarely present in a stable clinical condition. A man was referred to our hospital with the diagnosis of ruptured saccular aneurysm of the descending thoracic aorta. He successfully underwent both endovascular graft repair and open thoracotomy.

No MeSH data available.


Related in: MedlinePlus

Computed tomographic scan of the chest depicting the right pleural effusion along with atelectasis and the saccular aneurysm of the descending aorta.
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fig1: Computed tomographic scan of the chest depicting the right pleural effusion along with atelectasis and the saccular aneurysm of the descending aorta.

Mentions: A 65-year-old male was admitted to a regional hospital complaining of progressive cough and respiratory discomfort. The patient had a disease-free history, but for a cervical abscess and mediastinitis due to neglected dental inflammation, for which he had been submitted to drainage through a right lateral cervical incision two years before. Chest radiography revealed right pleural effusion. Apart from anemia (Ht: 32%) and elevated CRP, all other parameters were normal. Symptoms recessed after a total of 1,000 mL nonclotting bloody fluid drainage through thoracentesis. The fluid analysis showed hematocrit 6.2%, WBC 2.4 × 10 cells/L with 22% neutrophils and 75% lymphocytes, glucose 84 mg/dL, LDH 832 IU/L, and protein 5.5 g/dL, and its cytologic examination was negative for malignancy. The differential diagnosis was quite broad, including most lesions producing exudative fluid such as tumors of the lung, pleura, or mediastinum. During the next days the patient was mildly febrile, while cough and respiratory discomfort regressed. Computed tomographic scan of the chest confirmed the right pleural effusion along with atelectasis and revealed a saccular aneurysm of the descending aorta in front of T9 vertebra (Figure 1). It measured 2.4 cm, 1.5 cm, and 2.6 cm in longitudinal, transverse, and oblique diameters, respectively, and communicated with thoracic aorta through a lumen of 16 × 10 mm width. The aortic diameter above the orifice was 32 mm and below the orifice 30 mm. The radiologist assumed that minor rupture might exist. The patient was transferred to a tertiary hospital immediately.


Late diagnosis of silent thoracic aortic rupture presented as a right pleural effusion.

Kanakis MA, Papavassiliou VG, Drosos P, Kaperonis EA, Benakis G, Lioulias AG - Case Rep Med (2012)

Computed tomographic scan of the chest depicting the right pleural effusion along with atelectasis and the saccular aneurysm of the descending aorta.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539670&req=5

fig1: Computed tomographic scan of the chest depicting the right pleural effusion along with atelectasis and the saccular aneurysm of the descending aorta.
Mentions: A 65-year-old male was admitted to a regional hospital complaining of progressive cough and respiratory discomfort. The patient had a disease-free history, but for a cervical abscess and mediastinitis due to neglected dental inflammation, for which he had been submitted to drainage through a right lateral cervical incision two years before. Chest radiography revealed right pleural effusion. Apart from anemia (Ht: 32%) and elevated CRP, all other parameters were normal. Symptoms recessed after a total of 1,000 mL nonclotting bloody fluid drainage through thoracentesis. The fluid analysis showed hematocrit 6.2%, WBC 2.4 × 10 cells/L with 22% neutrophils and 75% lymphocytes, glucose 84 mg/dL, LDH 832 IU/L, and protein 5.5 g/dL, and its cytologic examination was negative for malignancy. The differential diagnosis was quite broad, including most lesions producing exudative fluid such as tumors of the lung, pleura, or mediastinum. During the next days the patient was mildly febrile, while cough and respiratory discomfort regressed. Computed tomographic scan of the chest confirmed the right pleural effusion along with atelectasis and revealed a saccular aneurysm of the descending aorta in front of T9 vertebra (Figure 1). It measured 2.4 cm, 1.5 cm, and 2.6 cm in longitudinal, transverse, and oblique diameters, respectively, and communicated with thoracic aorta through a lumen of 16 × 10 mm width. The aortic diameter above the orifice was 32 mm and below the orifice 30 mm. The radiologist assumed that minor rupture might exist. The patient was transferred to a tertiary hospital immediately.

Bottom Line: Patients with ruptured thoracic aortic aneurysm rarely present in a stable clinical condition.A man was referred to our hospital with the diagnosis of ruptured saccular aneurysm of the descending thoracic aorta.He successfully underwent both endovascular graft repair and open thoracotomy.

View Article: PubMed Central - PubMed

Affiliation: Thoracic Surgery Department, Sismanoglio General Hospital, 1 Sismanogliou Street, Marousi, 151 26 Athens, Greece.

ABSTRACT
Patients with ruptured thoracic aortic aneurysm rarely present in a stable clinical condition. A man was referred to our hospital with the diagnosis of ruptured saccular aneurysm of the descending thoracic aorta. He successfully underwent both endovascular graft repair and open thoracotomy.

No MeSH data available.


Related in: MedlinePlus