Aortopulmonary Shared Sheath Hematoma

Aortopulmonary shared sheath hematoma is a rare complication of acute aortic syndromes and can occur in the setting of focal rupture of the ascending aortic wall into the common aortopulmonary adventitia. It has been described in the setting of ascending aortic dissection, intramural hematoma, or ruptured aortic aneurysm. Aortic wall rupture into this shared space leads to a hematoma that can extend along the pulmonary arteries and result in extraluminal compression and narrowing of the pulmonary arteries. It is essential for radiologists to recognize the imaging features of aortopulmonary shared sheath hematoma to promptly alert the clinical team, to ensure accurate diagnosis, and to guide urgent management.