PMC6525833_01
CT scan of the abdomen. (a) Showing gallstones (arrow) with questionable gallbladder wall thickening or pericholecystic fluid. (b) Moderate amount of fluid in the pericardial space appears to be of increased density compared to simple fluid, suggestive of hemorrhage (arrow).
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Computed tomography (CT) scan of the abdomen was performed as an outpatient as part of the preoperative workup which showed evidence of gallstones, small bilateral pleural effusions, and moderate pericardial effusion with high density suggestive of hemorrhage (Figure 1).
CXR of the lungs (posteroanterior view) on admission shows a mildly enlarged cardiomediastinal silhouette that resembles a bottle.
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Chest x-ray showed a mildly enlarged cardiomediastinal silhouette with prominent perihilar opacities suggestive of a prominent vasculature (Figure 2).
H&E stain of biopsy of pericardial tissue showing thickened pericardial tissue with acute and chronic inflammation and reactive mesothelial hyperplasia.
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Pericardial tissue biopsy showed acute and chronic inflammatory cells with thickened pericardium, and no malignant cells were detected (Figure 3).
CT scan of the abdomen showing acute ascending thoracic aortic aneurysm measuring up to 7.5 cm with a dissection of the proximal ascending thoracic aorta originates approximately 1.3 cm above the aortic root. (a) Sagittal view of dissection site and (b) coronal view of dissection site. The area of dissection highlighted with an arrow.
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CT scan of the chest with contrast was obtained to evaluate for possible malignancy. CT showed an ascending aortic aneurysm measuring up to 7.5 cm with chronic dissection with no involvement of the coronaries or the great vessels (Figure 4).