Cases by Disease Category
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- Cases by Disease Category
- Mediastinum
Case No : 1238 Date 2021-07-13
- Courtesy of Suyon Chang / Seoul Seoul St. Mary's Hospital
- Age/Sex 79 / F
- Chief ComplaintHemoptysis, fever
Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Ruptured infected aortic aneurysm (pseudoaneurysm)
- Radiologic Findings
- Fig 1. Chest PA shows a mass surrounded by the air density and outer thick rim in the left upper mediastinum. The trachea is deviated to the right.
Fig 2-4. Chest CT scan reveals a mass in contact with the aortic arch, with surrounding mesh-like layered air density and outer thick soft tissue density rim in the left superior mediastinum. Disrupted intimal calcifications are noted.
Fig 5. Chest X-ray after 9 days showed a rapid increase in the size of the mass compared with the previous X-ray.
- Brief Review
- An infected aneurysm is rarely seen in the thoracic aorta. Aortic infection develops when a pathogen offends a vulnerable vessel wall. The focus of infection can develop in a normal caliber vessel or an existing aneurysm. Patients present with fever, chest pain, hemoptysis, and respiratory symptoms, which may be misdiagnosed as pneumonia, especially in patients with no history of aneurysm. Treatment consists of antibiotics and urgent surgery. The overall mortality rate is 16%
- References
- 1. Thanila A. Macedo, Anthony W. Stanson, Gustavo S. Oderich, C. Michael Johnson, Jean M. Panneton, and Mark L. Tie, Infected Aortic Aneurysms: Imaging Findings, Radiology 2004 231:1, 250-257
2. P. Ramadas, P. Krishnan, V.T. Chandrasekar, C.A. Gilman, N. Gnanabakthan, J. Lamichhane, Infected aortic aneurysmal rupture masquerading as pneumonia, QJM: An International Journal of Medicine, Volume 109, Issue 5, May 2016, Pages 343 - Keywords
No. of Applicants : 100
- ▶ Correct Answer : 48/100, 48.0%
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- - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
- - , Japan HIROAKI ARAKAWA
- - Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
- - Showa General Hospital , Japan MASAFUMI KAIUME
- - Mayo Clinic , United States AKITOSHI INOUE
- - National cancer center hospital east , Japan SHIOTO ODA
- - Other , Korea (South) HYEJIN YANG
- - Chonbuk National University Hospital , Korea (South) MINGI SHIN
- - McGill University Health Center , Canada ALEXANDRE SEMIONOV
- - CHCB , France LE GUEN RAPHAEL
- - Osaka Red Cross Hospital , Japan YUSUKE UTSUNOMIYA
- - , Italy PAOLO BALDASSARI
- - , France CHARLES DAMIEN
- - Tiger Gate Hospital , Japan SHIN-ICHI CHO
- - Inje University Pusan Paik Hospital , Korea (South) DA SOM KIM
- - Asan Medical Center , Korea (South) HYUN JUNG KOO
- - , Korea (South) JIN YOUNG LEE
- - National Center for Global Health and Medicine , Japan MASATOSHI HOTTA
- - HHS , Canada S LEE
- - Inje University Pusan Paik Hospital , Korea (South) JIYEON HAN
- - Yeungnam University Medical Center , Korea (South) JONGSOO PARK
- - Presbyterian Medical Center , Korea (South) SOOYEON JEONG
- - Gifu University Hospital , Japan Yo Kaneko
- - McGill , Canada MUTAZ ADNAN KHAIRO
- - , Korea (South) EUNJIN LEE
- - , Korea (South) SEUNGHYUN LIM
- - Other , Korea (South) MARI A
- - MAGNUM DIAGNOSTICS - Goa INDIA , India PARESH K DESAI
- - Osaka City General Hospital , Japan SHU MATSUSHITA
- - Chungbuk National University Hospital , Korea (South) MIHYEON PARK
- - Other , Korea (South) MINSU KIM
- - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
- - Seoul Veterans Hospital , Korea (South) SEONG WON JANG
- - , Japan HIROAKI ARAKAWA
- - Columbia asia refferal hospital,Bengaluru , India PRAVIN KUMAR M
- - Kyemyung University School of Medicine , Korea (South) YOUNG EUN BAHN
- - Holy Family Hopsital , India RAJESH GOTHI
- - Kyoto University Hospital , Japan SATOSHI IKEDA
- - Fortis hospital , Mohali , India SHALEEN RANA
- - Samsung Medical Center , Korea (South) SUHO KIM
- - Apollo Hospitals , India SHRUTHI P
- - Other , Korea (South) SUNYOUNG PARK
- - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
- - The University of Tokyo Hospital , Japan HIROSHI TAKUMIDA
- - Columbia asia radiology group , India VIKHYATH SHETTY Y
- - Diagnose.me (BV) / Royal Perth Hospital , Australia YURANGA WEERAKKODY
- - , Korea (South) WONJU HONG
- - algeria , Algeria ZAKARIA CHERAGA
- ▶ Correct Answer as Differential Diagnosis : 13/100, 13.0%
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- - Korea University Guro Hospital , Korea (South) SEOKYOUNG LEE
- - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
- - Other , Korea (South) HEE SEOK CHOI
- - Muhimbili National Hospital , Tanzania FREDERICK RICHARD LYIMO
- - VDC, HYDERABAD , India KARTHIK RAYASAM
- - Mallinckrodt Institute of Radiology , United States NAGANATHAN MANI
- - Avrasya Hospital/ISTANBUL , Turkey MURAT ULUSOY
- - CHU Lille , France PAUL LEBERT
- - Chonnam National University Hospital , Korea (South) KIM SANG GYUN
- - Chonnam National University Hospital , Korea (South) SOMIN LEE
- - Toranomon Hospital , Japan KAORU SUMIDA
- - Chonbuk National University Hospital , Korea (South) DONG HAN SHIN
- - Chonnam National University Hospital , Korea (South) SEUNG WAN KANG
- ▶ Semi-Correct Answer : 11/100, 11.0%
-
- - Chungbuk National University Hospital , Korea (South) YEONGTAE PARK
- - Osaka University , Japan AKINORI HATA
- - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
- - , Japan KANAE TAKAHASHI
- - The University of Tokyo Hospital , Japan RYO KUROKAWA
- - Seoul National University Hospital , Korea (South) SE WOO KIM
- - Yonsei University,Severance Hospital , Korea (South) HYUNGHU KIM
- - Nishida Hospital , Japan SHOJI OKUDA
- - , Japan KAZUMA TERAUCHI
- - National Center for Global Health and Medicine , Japan TOMOKI IMOKAWA
- - Private sector , Greece VASILIOS TZILAS
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