An 87 year old man presented with epigastric and interscapular pain.
Note the anterior penetrating ulcer of the descending thoracic aorta and the long segment circumferential intramural haematoma. This progressed to frank leakeage over the next few days and was finally stented. This patient has a AAA too.
Good article here: http://radiographics.rsnajnls.org/cgi/content/full/20/4/995
Good summary here: http://www.learningradiology.com/notes/cardiacnotes/penetratingulcerpage.htm
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