POSTSCRIPT
Letters to the editor
Oesophageal rupture due to tuberculous pseudoaneurysm of the aorta
1 TN Medical College and BYL Nair Hospital, Bombay Central, Mumbai, India
2 Department of Pathology, Seth G. S. Medical College, Parel, Mumbai, India
Correspondence to:
Dr G P Amonkar, Dept of Pathology, TN Medical College, BYL Nair Hospital, Mumbai 400 08, Maharashtra, India; gpamonkar@hotmail.com
Accepted 16 February 2009
| The first 150 words of the full text of this article appear below. |
Tuberculous pseudoaneurysm (TPA) of the aorta is a rare complication of tuberculosis.1–5 Rupture of TPA into the digestive tract is even rarer, with only a few cases being reported in the literature.4 Clinical awareness of TPA of the aorta is imperative as prompt therapy with a combination of surgery and antituberculous therapy with follow-up has shown excellent results in this otherwise fatal condition.1
A 60-year-old male patient presented with massive haematemesis and died suddenly. At autopsy, the thoracic aorta showed a 2 cm ragged tear with formation of a 4x3 cm outpouching that appeared to be walled off by fibrous tissue and caseous necrosis (fig 1). This outpouching in turn had ruptured into the oesophagus, producing a 2 cm ulcerative lesion rupturing into the mucosa (fig 2). There were blood clots in the oesophagus and stomach weighing 500 gm. Microscopy
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