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A 68-year-old man presented with acute thoracic, abdominal, and back pain and progressive shock. In the past, he had undergone repair of an abdominal aortic aneurysm, bilobar wedge resection, and chest-wall resection because of a left-sided Pancoast's tumor. At that time, the thoracic aorta measured 5.6 cm in diameter just above the diaphragm, but there was kinking in the lower third of the descending aorta with a large mural thrombus (Panel A). On admission, physical examination revealed a cyanotic face and neck with distended neck veins. The blood pressure was 88/47 mm Hg. Computed tomographic scanning revealed a ruptured aneurysm . . . [Full Text of this Article] |
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