CTICasesPost-Traumatic Aortic Pseudoaneurysm
Imaging findings
Frontal and lateral chest radiographs demonstrate a prominent, heavily calcified contour projecting from the distal aortic arch and proximal descending aorta near the isthmus. The calcification shows a thick, irregular, rind-like pattern rather than typical atherosclerotic changes. Chest CT confirms a saccular pseudoaneurysm arising from the proximal descending aorta just distal to the ligamentum arteriosum, with prominent peripheral calcification. Associated remote, healed rib fractures are visible on the adjacent chest wall.
Key takeaways
Saccular pseudoaneurysms of the proximal descending aorta can persist silently for decades following blunt chest trauma. The presence of adjacent healed rib fractures is a helpful clue to the traumatic etiology. Recognition of the classic location distal to the ligamentum arteriosum and distinctive dense calcification helps differentiate post-traumatic pseudoaneurysms from simple atherosclerotic aneurysms.
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