Penetrating Atherosclerotic Ulcer: Another Differential Diagnosis of Widened Mediastinum.
- Author:
Sung Bin CHON
1
;
Chan Woo PARK
;
Jun Hwi CHO
;
Kil Soo YIE
Author Information
1. Department of Emergency Medicine, Kangwon National University Hospital, Chuncheon, Korea. cjhemd@kangwon.ac.kr
- Publication Type:Case Report
- Keywords:
Aorta;
thoracic;
Aortic aneurysm;
Aortic rupture;
Chest pain;
Ulcer
- MeSH:
Aged;
Aorta;
Aorta, Thoracic;
Aortic Aneurysm;
Aortic Rupture;
Chest Pain;
Diagnosis, Differential;
Emergencies;
Hematoma;
Humans;
Mediastinum;
Pericardial Effusion;
Ulcer
- From:Journal of the Korean Society of Emergency Medicine
2011;22(5):566-569
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A widened mediastinum is not always caused by aortic dissection, which is the default diagnosis among emergency physicians. Other acute aortic syndromes should be included in differential diagnosis, such as penetrating atherosclerotic ulcer (PAU), intraluminal hematoma, aneurismal leak, and traumatic transection. When an ulcerative lesion is found in the atherosclerotic aorta, especially the descending aorta of an elderly, PAU should be considered as the possible cause of widened mediastinum. We present a case of PAU, the diagnosis of which was delayed without the knowledge of PAU even though thoracic computed tomography showed widened mediastinum and suspious pericardial effusion.
