Ductus diverticulum

Last revised by Andrea Molinari on 12 Mar 2024

Aortic ductus diverticulum is a developmental outpouching of the thoracic aorta which may be mistaken for an acute aortic injury.

Gross anatomy

It is usually seen at the anteromedial aspect of the aorta at the site of the aortic isthmus, where the ligamentum arteriosum attaches. It is also the site of the majority (~90%) of post-traumatic aortic injuries as the ligamentum arteriosum is one of the points to which the thoracic aorta is tethered; therefore, differentiation of ductus diverticulum from traumatic pseudoaneurysm is vitally important.

In contrast to an aortic pseudoaneurysm, which usually forms sharp margins with the aorta, the ductus diverticulum usually appears as a smooth focal bulge with gentle obtuse angles with the aortic wall.

Types

Ductus diverticula are divided into:

  • classic

    • smooth gentle shoulders

    • 33% newborns

    • 9% adults

  • atypical

    • sharper with a shorter and steeper superior slope

Differential diagnosis

For differentiating features, see aortic pseudoaneursym versus ductus diverticulum.

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