CTICasesAcute Aortic Pseudoaneurysm
Imaging findings
Sequential chest radiographs over a 10-day period show progressive mediastinal widening, depression of the left mainstem bronchus, and tracheal deviation to the right. CT angiography of the chest confirms the presence of a large, focal pseudoaneurysm originating from the aortic isthmus with surrounding hematoma.
Key takeaways
Acute aortic pseudoaneurysm can develop rapidly and manifest subtle serial changes on chest radiographs, including progressive widening of the aortic arch contour, depression of the left main bronchus, and deviation of the trachea. Prompt recognition of these radiographic signs in a patient with ongoing chest pain is vital to prevent catastrophic rupture, and treatment typically involves urgent endovascular stenting (TEVAR).
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