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Weekly Chest CasesArchive of Old Cases

Case No : 644 Date 2010-03-01

  • Courtesy of Jung Im Kim, Chang Hyun Lee / Seoul National University Hospital
  • Age/Sex 45 / F
  • Chief ComplaintIncidentally found lesion in chest X-ray and CT
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5

Diagnosis With Brief Discussion

Diagnosis
RVOT pseudoaneurysm
Radiologic Findings
There is a round mass like lesion with calcified rim in the mediastinum on chest CT scan. The lesion is inside the pericardium (Fig 3,4). On operative findings, traumatic pseudoaneurysm was confirmed and the origin was right ventricular outflow tract.
Brief Review
A pseudoaneurysm, also known as a false aneurysm, is a hematoma that forms as the result of a leaking hole in an artery. Note that the hematoma forms outside the arterial wall, so it is contained by the surrounding tissues. Also it must continue to communicate with the artery to be considered a pseudoaneurysm.

Pseudoaneurysm of the right ventricular outflow tract (RVOT) is a rare complication of cardiac surgical procedures done for congenital heart disease. In the literature, the initial procedures included right ventriculotomy and placement of an outflow patch, conduit, or homograft. The treatment should be carried out soon after diagnosis because of the risk of spontaneous rupture.

References
Keywords
Vascular, Trauma,

No. of Applicants : 92

▶ Correct Answer : 9/92,  9.8%
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - McGill University , Canada Ben Smith
  • - SAISEIKAI KURIHASHI HOSPITAL , Japan YASUO OKUBO
  • - Song-do Hospital , Korea (South) Ji-young Yun
  • - Univ. of Miami/Jackson Memorial , United States mantosh rattan
  • - Vital Imaging Centre, Mumbai,India , India Ganesh Agrawal
  • - Retd. Prof Thoracic Surgery B.J.MEDIDCAL COLLEGE Punr India , India Bankim Amin
  • - SoonChunHyang univ. hospital , Korea (South) Kim Jae Hyun
  • - seoul national university hospital , Korea (South) Ijin Joo
▶ Correct Answer as Differential Diagnosis : 15/92,  16.3%
  • - care hospital , India Chary D
  • - Shiga University of Medical Science , Japan Norihisa Nitta
  • - CHRU lille , France manuel toledano
  • - radiologist, aditya imaging centre , India vivek patel
  • - Samsung Medical Center , Korea (South) Eun Kim
  • - University of British Columbia , Canada Amr Ajlan
  • - CHRU Lille , France guillaume lefebvre
  • - SMG-SNU boramae medical center , Korea (South) Kwang Nam Jin
  • - Hangang Sacred Heart Hospital , Korea (South) Eil Seong Lee
  • - NTUH , Taiwan Kuei-pin Chung
  • - ICD Calicut, MCCH Thrissur , India Arun P
  • - royal melbourne hospital , Australia stefan heinze
  • - IRCCS Istituto Oncologico - Bari , Italy Carlo Florio
  • - NASA SCANS , India RAKESH BHATIA
  • - clinique de SAVOIE , France, Metropolitan gay-depassier philippe
▶ Semi-Correct Answer : 1/92,  1.1%
  • - Dong-A university hospital , Korea (South) Sang-yun LEE
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Current Editor : Sung Shine Shim, MD, PhD. Email : sinisim@ewha.ac.kr

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