What is the clinical evidence from this study?

Study design: Case Report. Population: Ruptured Penetrating Aortic Ulcer with Hemopericardium (n=1). Intervention: Emergent surgical repair (median sternotomy and ascending aorta replacement).

What question did this study set out to answer?

To describe the clinical presentation, emergency diagnosis, and surgical management of a ruptured penetrating ascending aortic ulcer presenting with hemopericardium in a young adult.

May 26, 2026CureusOpen Access

Ruptured Penetrating Aortic Ulcer With Hemopericardium in a Young Adult: A Case Report

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Key result

Emergent surgical repair of a ruptured ascending penetrating aortic ulcer achieves successful 3-month survival.

Why the study?

Penetrating aortic ulcer is rare and highly lethal, especially with ascending aortic involvement, but typically occurs in elderly patients rather than young adults.

Key Points

To describe the clinical presentation, emergency diagnosis, and surgical management of a ruptured penetrating ascending aortic ulcer presenting with hemopericardium in a young adult.
Clinical evaluation and diagnostic workup of a 33-year-old male with poorly controlled hypertension who presented with chest pain and syncope.
Diagnostic assessment using serial cardiac troponin T testing, electrocardiography, transthoracic echocardiography, and emergent computed tomographic angiography (CTA) of the chest.
Emergency helicopter transfer to a tertiary surgical center for median sternotomy and ascending aortic repair.
Chest CTA demonstrated a 15 mm craniocaudal by 4 mm deep penetrating aortic ulcer in the ascending aorta with intramural hematoma and circumferential hemopericardium.
The patient underwent emergent replacement of the ascending aorta using a 32 mm Gelweave vascular prosthesis (cardiopulmonary bypass time of 108 minutes, cross-clamp time of 73 minutes) and was discharged on postoperative day 6.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Population

33-year-old Caucasian male with longstanding poorly controlled hypertension, congenital spina bifida, and Chiari II malformation, presenting with sudden-onset chest pain and syncope.

Intervention

Emergent median sternotomy for repair of the ascending aortic rupture with a 32 mm woven vascular prosthesis.

This case highlights the importance of maintaining clinical suspicion for acute aortic pathology in young adults with hypertension and the critical role of rapid CTA and systems-based coordination for emergent surgical repair.

Discussion

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Implication

Highlights need for suspicion of aortic pathology in young hypertensives; leaves open optimal strategies pending further data.

Cite This Study

Patel et al. (2026) conducted a case report in Ruptured Penetrating Aortic Ulcer with Hemopericardium (n=1). Emergent surgical repair (median sternotomy and ascending aorta replacement) was evaluated. Emergent surgical repair of a ruptured ascending penetrating aortic ulcer in a 33-year-old male resulted in successful recovery and survival at 3-month follow-up.

synapsesocial.com/papers/6a153ce3b5d9c58d83e8d552 https://doi.org/10.7759/cureus.109550

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Ruptured Penetrating Aortic Ulcer With Hemopericardium in a Young Adult: A Case Report

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Ruptured Penetrating Aortic Ulcer With Hemopericardium in a Young Adult: A Case Report

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider