Presentation
Aortic alteration discovered incidentally on chest radiograph.
Patient Data
Unenhanced CT of the aorta shows thick irregular parietal atherosclerotic plaques. The angiographic phase displays an extensive saccular dilatation of the descending aorta with thick mural thrombus of semilunar shape. Slight displacement of the left tracheobronchial tree. No evidence of rupture or aortic dissection. The spleen shows multiple punctiform calcifications. Liver. pancreas, kidneys and adrenal glands within normal limits
Case Discussion
These findings are consistent with a thoracic aortic aneurysm with no evidence of complications
Like in this case, one of the challenges of a thoracic aneurysm with thrombus is distinguished from a dissection with a thrombosed lumen. Intimal calcifications may be helpful in dissecting since these are displaced by the false lumen.
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