Hemoptysis: a rare presentation of aortic Pseudoaneurysm. Nitesh Tayal, Sharad Joshi, Rajesh Gupta; The Egyptian Journal of Chest Diseases and Tuberculosis 2019, 68:263–265

Post Date: November 24, 2021

Aortic pseudoaneurysm presenting as haemoptysis is a very rare clinical entity [1]. Case reports have shown that thoracic aortic aneurysm can rupture into adjacent structures such as trachea and bronchi, pericardial and pleural cavities, and even esophagus [2]. Aortic aneurysm can cause erosion of trachea or may rarely rupture into the lung, resulting in haemoptysis [1]. Very few cases of pseudoaneurysm presenting as haemoptysis have been reported worldwide in the literature.


A 70-year-old male presented with the complaint of cough, recurrent haemoptysis, hoarseness of voice, and weakness for past 3–4 days. Patient is a known case of hypertension. There was no history of trauma, pulmonary tuberculosis, bronchiectasis, any previous cardiac surgery, or any pre-existing lung disease. On examination, patient was conscious and oriented with heart rate of 84/min and blood pressure of 130/80 mmHg. Other local and systemic examinations were within normal limits. His routine investigations showed hemoglobin of 11.8 g/dl, total leukocyte count of 7050 cells/mm3, and platelet count of 1.76 lakh/dl. Liver function test and kidney function test (KFT) were within normal limits. His coagulation profile was normal.

Chest radiography ([Figure 1]) was done, which was suggestive of mediastinal widening. Computed tomography aortogram ([Figure 2]a and b) was done, which showed evidence of sac showing central hyperattenuating with peripheral hypoattenuating areas, seen in communication with descending aorta, likely to represent pseudoaneurysm with chronic perianeurysmal thrombus along with diffuse atherosclerotic wall thickening with calcification seen along arch of aorta, descending aorta, abdominal aorta and its major branches, without causing significant luminal compromise. His lung parenchyma was normal. So diagnosis of pseudoaneurysm was made, and the patient underwent peripheral angiography with aortic stent grafting with vascular embolization with vascular repair. Postprocedure chest radiography showed stent in place ([Figure 3]). After the procedure, patient condition improved, and he was discharged in stable condition. There were no episodes of haemoptysis after the procedure.