A ruptured descending thoracic aorta pseudo aneurysm in a child presented with chest pain having untreated aortic coarctation: A case report

INTRODUCTION: Coarctation of aorta is a congenital narrowing of the aorta commonly involving periductal segment of descending aorta. It commonly occurs as an isolated lesion and if left untreated it may result in hypertension, aneurysm and aortic rupture. CASE PRESENTATION: A previously healthy 10 years old male child presented with sudden onset of chest pain associated with shortness breath. Contrast enhanced computed tomography of the chest revealed a narrowed segment of proximal descending aorta with vascular enhancing out pouching surrounded by massive non enhancing posterior mediastinal collection. Resection and interposition grafting with synthetic tube was done for ruptured pseudo aneurysm complicating coarctation. DISCUSSION: Coarctation of aorta incidence is two to five times higher in males and its incidence increases with congenital cardiac lesions associated with decreased blood flow through the aorta. Clinical presentation varies with age at presentation so related with severity of the disease. Diagnosis can be made with echocardiography and computed tomography. Options of management and materials to be used are controversial issues but also determined by age and mode of presentation. CONCLUSION: Aortic pseudo aneurysm is a rare complication of coarctation which may rupture requiring urgent surgical intervention.