A 79-year-old-man with a 'niveau' on a chest radiograph. (6th July 2015)

• Record Type: Journal Article
• Authors: Suu, Kanae; Kato, Takao; Inoko, Moriaki
• Is Part Of: BMJ case reports. Volume 2015
• Publication Date: 2015-07-06
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2014-208423
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : A 79-year-old man was referred to the emergency room following a sudden episode of 'spitting blood', with a blood pressure of 128 (systolic) and 75 mm Hg (diastolic) and a heart rate of 60 bpm. His medical history included the treatment of gastric cancer and untreated hypertension. At that time, his symptoms were limited without any chest, back or abdominal pain. After a presentation of haemoptysis was confirmed, a chest radiograph revealed an air-fluid level (a 'niveau') that was continuous towards the enlarged thoracic aorta and the thoracic cavity. Contrast-enhanced CT was subsequently performed, and revealed an aortic dissection and a pneumothorax adjacent to the dissection, accompanied by blood pooling in the thoracic cavity. The patient died 40 min after the admission to the emergency room due to an additional haemoptysis. The autopsy confirmed the diagnosis of a ruptured aortic dissection with pneumothorax.