A ruptured thymic branch aneurysm mimicking a ruptured aortic aneurysm, with associated bronchial artery aneurysms: report of a case.
A 57-year-old woman who went into shock following an acute left hemothorax was operated on after stabilization under the diagnosis of a ruptured aortic aneurysm. A left fifth intercostal thoracotomy was done which revealed approximately 500 ml of bloody effusion in the extrapleural space and 2,000 g of clotted blood in the pleural cavity. While the aneurysm was initially thought to have originated in the isthmic or descending aorta, intraoperative findings revealed a swollen hematomatous thymus adherent to the aorta. A ruptured thymic branch aneurysm, 3 cm in diameter, was subsequently found in the resected hematomatous thymus. Histological examination also revealed several small aneurysms in the tortured bronchial arteries. Postoperative angiography showed a saccular aneurysm, 1.5 cm in diameter, and several smaller aneurysms in the bronchial artery of the left lung. The aneurysm was successfully treated by a transcatheter arterial embolization, and the patient has had no further symptoms since then. To our knowledge, there has been no other case of a ruptured thymic artery aneurysm reported in the literature, and only a few cases of bronchial artery aneurysms have been documented.
Komoda
K
K
Third Department of Surgery, School of Medicine, Iwate Medical University, Japan.
Hujii
Y
Y
Nakajima
T
T
Abe
K
K
Hamada
Y
Y
Niitu
K
K
Sasou
S
S
D000783:Aneurysm / Q000150:complications / Q000175:diagnosis*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis*; D001019:Aortic Rupture / Q000175:diagnosis*; D001981:Bronchial Arteries; D003937:Diagnosis, Differential; D005260:Female; D006491:Hemothorax / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D013895:Thoracic Arteries