[Rupture of the descending thoracic aortic aneurysm in the lung: report of a case].

ABSTRACT

A 65-year-old man underwent a prosthetic graft replacement for a rupture of the saccular descending thoracic aneurysm in the lung. Chest computed tomography (CT) performed on the day of admission was suggestive of a thrombosed localized aortic dissection. However, sagittal plane CT performed on the following day indicated the rupture of a penetrating atherosclerotic ulcer. The operation was performed approximately 36h after the onset of the symptom since diagnosis was difficult due to the following reasons. First, the size of the saccular aortic aneurysm was not sufficiently large, i.e., it was 4.5 cm diameter and 3.0 cm in length. Second, the aneurysm was completely filled with thrombus therefore, it could not be enhanced on CT scanning. Third, since the aneurysm was present on the side of the greater curvature of the descending aorta, the protrusion of the aneurysm was very indistinct. Fourth, the amount of bleeding was not significant because the rupture was extremely small, approximately 2 mm in width. Fifth, only an interlobar hematoma was observed due to the tight adhesion of the lung with the aorta.