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KMID : 0385920110220050566
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Journal of the Korean Society of Emergency Medicine
2011 Volume.22 No. 5 p.566 ~ p.569
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Penetrating Atherosclerotic Ulcer: Another Differential Diagnosis of Widened Mediastinum
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Chon Sung-Bin
Park Chan-Woo
Cho Jun-Hwi
Lee Kil-Soo
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Abstract
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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.
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KEYWORD
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Aorta, thoracic, Aortic aneurysm, Aortic rupture, Chest pain, Ulcer
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