Complicated Intramural Hematoma with Medionecrosis of the Aortic Wall.

Daniel Anderson,Natalie Gaughan,Rosmi P Thomas,Stefano Schena

doi:10.1055/s-0041-1729849

Abstract

Medionecrosis and medial degeneration are rare complications associated with intramural hematomas (IMHs). We present a case of a 69-year-old Asian female with an IMH with medionecrosis and medial degeneration of the aortic wall. The patient underwent successful surgical intervention, and pathological findings were significant for cystic medial degeneration of the aortic wall.

Highlights

Acute aortic syndromes (AAS) are a spectrum of severe aortic syndromes triggered by a rupture of the vasa vasorum which causes bleeding within the media or permits blood to penetrate from the aortic lumen into the media layer.[1]
Ascending aortic hematomas (Type A) present with chest pain, while descending aortic hematomas (Type B) manifest with upper or lower back pain.[3]. The presentation within this case of a Type A intramural hematomas (IMHs) with upper back pain highlights the importance of imaging in diagnosing an IMH.[1]
Despite the physiologic difference in Type A IMH and ADs, there is no significant difference in in-hospital mortality between the two pathologies.[5]

Summary

Introduction

Acute aortic syndromes (AAS) are a spectrum of severe aortic syndromes triggered by a rupture of the vasa vasorum which causes bleeding within the media (intramural hematoma [IMH]) or permits blood to penetrate from the aortic lumen into the media layer (aortic dissection [AD]).[1]. Medionecrosis and medial degeneration are rare complications associated with intramural hematomas (IMHs).

Results

Conclusion