Case 3

This is a CT chest study with non-contrast and post-contrast series provided in the arterial phase, demonstrating eccentric thickening of the aortic wall from the aortic arch down to the abdominal aorta. On the non-contrast images, the thickened part of the aortic wall shows relatively high density in a crescentic shape. These findings are highly suggestive of a type B aortic intramural haematoma. I note that there is no intimal flap / tear, no aortic ulcer, and no mediastinal haematoma or pleural effusion to suggest leakage.

I would immediately inform the referring physician of these findings and recommend urgent cardiothoracic / vascular surgery referral.