PMC6732609_01
Chest X-ray obtained on admission showing left lower lung infiltrate, with blunting of the adjacent costophrenic angle consistent with a pleural effusion.
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A chest radiograph revealed a tortuous, calcified aorta and a left pleural effusion with adjacent infiltrates (Figure 1).
Diffuse gaseous distention of the bowel consistent with ileus seen on abdominal X-ray.
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Abdominal X-ray revealed diffuse gaseous distension of the bowel consistent with ileus (Figure 2).
Sagittal view on chest CT obtained on admission (a). Note the presence of periaortic gas and inflammatory thickening of the aortic wall (arrowheads) without aneurysmal dilation, extending along the aortic arch and descending aorta. By admission day 10, CT findings showed resolution of the periaortic emphysema with interval development of nonspecific fluid and inflammatory changes (b).
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Incidentally, numerous foci of soft tissue gas were noted within the aortic wall, extending from the arch to the distal descending aorta (Figure 3(a)). CT showed fluid and inflammatory changes replacing the gas pockets seen on the initial study (Figure 3(b)). CT imaging of the abdomen with intravenous contrast was considered as a noninvasive alternative to evaluate the presence of any intra-abdominal malignancy since the patient was not stable to undergo colonoscopy.