Presentation
Severe chest pain after blunt chest trauma due to a car accident.
Patient Data
There is a small well defined outpouching of the proximal descending aorta (just distal to the origin of the left subclavian artery), in keeping with pseudoaneurysm.
Case Discussion
The findings of CT in a young patient with thoracic blunt trauma compatible with thoracic aortic pseudoaneurysm.
Trauma to the aorta may result in:
aortic intramural hematoma: hematoma within the wall of the aorta.
aortic pseudoaneurysm: aortic rupture contained by adventitia or periaortic tissue.
aortic laceration: a tear (typically transverse) in the intima which may extend through the vessel wall.
aortic transection: laceration of all three layers of the vessel wall.
An important differential diagnosis for this patient includes ductus diverticulum and differentiation of ductus diverticulum from a pseudoaneurysm is important.