PMC8675615_01
Computed tomography angiography of the chest demonstrates an ascending thoracic aortic aneurysm with saccular pseudoaneurysm formation. Arrows point to the aneurysm compressing the esophagus.
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f1
A month and a half prior to his presentation, computed tomography (CT) angiography of the chest to evaluate the TAA demonstrated an ascending TAA and saccular pseudoaneurysm formation from an ARSA, resulting in marked mass effect and displacement of the esophagus (Figure 1).
Esophagogastroduodenoscopy demonstrates (A) external compression into the lumen of the esophagus and (B) the inferior part of the compression with ulceration (arrows) and possible visible vessel.
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f2
Following initial resuscitation with 2 units of packed red blood cells and intravenous pantoprazole, esophagogastroduodenoscopy (EGD) was performed and demonstrated extrinsic compression of the upper third of the esophagus, with associated areas of ulceration and visible underlying vasculature (Figure 2).
Interventional radiology imaging demonstrates (A) precoiled pseudoaneurysm and (B) postcoiled pseudoaneurysm.
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f3
In conjunction with vascular surgery, interventional radiology performed a coil embolization of the ARSA pseudoaneurysm (Figure 3).