Penetrating atherosclerotic ulcer - aortic arch
Colorectal cancer for staging.
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A penetrating aortic ulcer with mural thrombus, measures 3.9 cm, extends from the inferior surface of the aortic arch.
Multiple pulmonary nodules consistent with metastases are demonstrated.
Annular mural thickening of the distal sigmoid colon and proximal rectum (not demonstrated).
Key learning points:
- along with aortic intramural hematoma and aortic dissection, penetrating atherosclerotic ulcers is a cause of acute aortic syndrome
- smoking and hypertension are the two main risk factors
- no intimal flap or false lumen is present on CT
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