Abstract
Fig. 1. (a) CT chest at the time revealed a brachiocephalic trunk aneurysm extending from the origin of the arch of the aorta all the way up to the thoracic inlet area measuring in excess of 8 cm 7 cm 6 cm with evidence of surrounding thrombus and multiple lymph nodes in the preand peri-carinal area with the largest measuring 2.0 cm. (b) The trachea and oesophagus were compressed by the aneurysm and displaced to the left side (Fig. 2). This explained the hoarseness of voice and dysphagia for liquids and solid food in patient. The two working diagnoses were an underlying vasculitic process or a pre-existing aneurysm that became secondarily infected and rapidly expanded as per patient’s blood and urine that grew E. coli.
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