TRAUMATIC RUPTURE OF AN AORTIC ULCERATIVE ATHEROSCLEROTIC PLAQUE PRODUCING AORTIC DISSECTION - A COMPLICATION OF INTERSCAPULAR BACK BLOWS USED TO DISLODGE OBJECTS FROM THE ESOPHAGUS

Penetrating atherosclerotic ulcer of the aorta is a rare entity which usually occurs in the descending thoracic aorta. Herein, we report an unusual case of penetrating aortic ulcer which ruptured into the media stinum. Interscapular back blows were performed on our patient in an a ttempt to dislodge an aspirin which she thought was lodged in her esop hagus. Unlike previously reported cases of this entity, the penetratin g aortic ulcer in our patient was located in the distal thoracic ascen ding aorta. Diagnosis of penetrating aortic ulcer can be made by utili zing aortography, contiguous dynamic contrast-enhanced computed tomogr aphy or magnetic resonance imaging. Treatment consists of adjunctive m edical therapy until surgery can be performed.