Contained rupture of a thoracic aortic aneurysm at the diaphragmatic hiatus: A case report

Contained rupture is a rare complication of aortic aneurysms and occurs less frequently in the thoracic aorta compared to the abdominal aorta. Rapid enlargement of a contained rupture is a high risk factor for free rupture. Radiography and cross-sectional imaging play a vital role in the prompt diagnosis of contained rupture, which is significant given its treatment may differ from that of other aortic complications. We describe a case of a 64-year-old man with multiple previous infections of the spine and bloodstream who underwent contrast-enhanced computed tomography of the chest, abdomen, and pelvis to evaluate acute hypoxic respiratory failure, hematuria, and abdominal pain. He was found to have an enlarged, contained rupture of a thoracic aortic aneurysm at the diaphragmatic hiatus. Surgical repair could not be performed due to chronic infection and underlying comorbidities.