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CLINICAL IMAGE
Year : 2020  |  Volume : 152  |  Issue : 7  |  Page : 14-15

Unusual aortic rupture: What is cold can become catastrophic!


1 Department of Radiodiagnosis (IRCH), All India Institute of Medical Sciences, New Delhi 110 029, India
2 Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi 110 029, India

Date of Submission15-Oct-2019
Date of Web Publication25-May-2021

Correspondence Address:
Sanjeev Kumar
Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_1783_19

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How to cite this article:
Chandrashekhara S H, Kumar S. Unusual aortic rupture: What is cold can become catastrophic!. Indian J Med Res 2020;152, Suppl S1:14-5

How to cite this URL:
Chandrashekhara S H, Kumar S. Unusual aortic rupture: What is cold can become catastrophic!. Indian J Med Res [serial online] 2020 [cited 2021 Sep 27];152, Suppl S1:14-5. Available from: https://www.ijmr.org.in/text.asp?2020/152/7/14/316730

Patient's consent obtained to publish clinical information and images.


An 18 yr old male patient with spinal tuberculosis presented to the department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India, in September 2018, with acute aortic rupture [Figure 1]A, [Figure 1]B, [Figure 1]C, [Figure 1]D. This was successfully managed with endovascular stent graft [Figure 1]E. Follow up computed tomography angiogram done after one month showed patent aortic stent graft with no leak [Figure 1]F. The patient is stable with patent aortic graft now. The patent was given anti-tuberculosis therapy (ATT) one month prior to the aortic stenting and continued for six months following the procedure. Pott's spine is one of the most common skeletal sites of extra-pulmonary tuberculosis, which can cause significant complications. The associated large para-vertebral abscess often erodes adjacent structures and rarely involves the aortic wall causing its dehiscence. The treatment of such devastating complications is controversial. Surgery, along with ATT, may be beneficial. However, it is quite challenging due to intra-operative complications and poor functional status of these patients.
Figure 1: Computed tomography (CT) showing abdominal aortic rupture into the tubercular paravertebral abscess. (A) Coronal view. (B) Sagittal view. (C) Volume-rendered CT reconstructions showing active contrast extravasation from the posterior wall of juxtadiaphragmatic aorta into the large paravertebral abscess (red arrow). Hyperdense contents (blood) noted in the abscess (asterisks). (D) Digital subtraction angiogram revealing active contrast extravasation from the abdominal aorta (red arrow). (E) Abdominal aortic stent graft was deployed with no contrast leak. (F) Follow up computed tomography after one month showing aortic stent graft with no leak.

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Conflicts of interest: None


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