Ruptured Penetrating Aortic Ulcer With Hemopericardium in a Young Adult: A Case Report.

Authors

Rian R Patel, Ayush A Kamdar, Sudeep Aryal

Published in

Cureus. Volume 18. Issue 5. Pages e109550. Epub May 24, 2026.

Abstract

Penetrating aortic ulcer (PAU) is a rare but highly lethal manifestation of acute aortic syndrome (AAS), most commonly seen in elderly patients with advanced atherosclerosis. Ascending aortic involvement is particularly uncommon but carries a high risk of rupture, hemopericardium, and cardiac tamponade. We present the case of a 33-year-old male with longstanding poorly controlled hypertension who presented to a community hospital with chest pain and syncope. Initial evaluation suggested acute coronary syndrome; however, computed tomography angiography revealed rupture of a penetrating ascending aortic ulcer with intramural hematoma and hemopericardium. The patient underwent prompt helicopter transfer to a tertiary care center and emergent surgical repair. He had an excellent postoperative recovery and remains well on follow-up. This case highlights the importance of maintaining clinical suspicion for acute aortic pathology, the diagnostic utility of computed tomography angiography, and the critical role of rapid systems-based coordination in achieving favorable outcomes in this high-mortality condition.

PMID:
42344818
Bibliographic data and abstract were imported from PubMed on 25 Jun 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.