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Infected Ruptured Pseudo-aneurysm in Descending Aorta; a Case Report

Morteza Sanei Taheri1, Sayyed Mojtaba Nekooghadam2, Zahra Sadat Tabatabaei1

  • 1Department of Radiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Shohada-e-Tajrish Hospital, Tehran, Iran.

Archives of Academic Emergency Medicine
|April 4, 2024
PubMed

Insights

This case report details a patient with diabetes and hypertension who experienced stroke symptoms. Diagnosis revealed an infected, ruptured aortic pseudoaneurysm, a rare but serious condition requiring urgent intervention.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Infectious Diseases

Background:

  • Aortitis, inflammation of the aortic wall, can stem from infectious or non-infectious causes.
  • Mycotic aneurysms are rare, life-threatening vascular infections requiring prompt management.
  • Early diagnosis and intervention are crucial to prevent catastrophic complications like aortic rupture.

Observation:

  • A 66-year-old male with diabetes and hypertension presented with stroke symptoms (hemiplegia).
  • Brain MRI indicated an embolic pattern of infarction.
  • Elevated inflammatory markers (ESR, CRP, WBC) and chest CT findings suggested mediastinal pathology, including potential aortic pseudoaneurysm.

Findings:

  • CT angiography confirmed an infected, ruptured aortic pseudoaneurysm.
  • The patient underwent emergency thoracotomy for surgical repair.

Implications:

  • This case highlights the importance of considering infectious aortitis and mycotic aneurysms in patients with embolic stroke and elevated inflammatory markers.
  • Prompt diagnostic imaging and multidisciplinary management are essential for favorable outcomes in these critical cases.
  • Highlights the diagnostic challenges and successful surgical management of a ruptured aortic pseudoaneurysm presenting with neurological deficits.
Keywords:
AneurysmBrain infarctionCase reportsComputed tomography angiographyRare diseasesfalseinfected

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