Subsequently, an endoscopy was performed which revealed a normal esophagus and a 7 mm (largest diameter), nonbleeding, penetrating ulcer in the posterior wall of the gastric antrum (Figure 2).
Endoscopic examination of our patient revealed a non-bleeding, penetrating ulcer in the posterior wall of the gastric antrum secondary to H.
Caption: Figure 2: Endoscopic image showing the penetrating ulcer in the posterior wall of the gastric antrum.
A penetrating ulcer should be distinguished from an atherosclerotic ulcer, which is confined to the intima, lacks intramural hematoma, and results in no symptoms.
Penetrating ulcer is usually managed medically, but open or endovascular repair is performed if patients become hemodynamically unstable or have persistent or worsening pain or have rapid ulcer enlargement, aortic rupture, or distal embolization of thrombus.
Rupture of an aneurysm, dissection, or penetrating ulcer can be contained or can be free when it extends into the mediastinum, pericardium, pleura or extrapleural space, esophagus, or bronchus.
There was moderate atherosclerosis in the arch of the aorta, but this was not complicated by a penetrating ulcer
, aneurysmal dilatation, or pseudoaneurysm formation.
(6,7) Thoracic intramural hematoma, penetrating ulcer and aortic dissection share clinical symptoms and patterns of progression, and are therefore collectively referred to as acute aortic syndrome (AAS) by some authors.
Intramural Hematoma, Penetrating Ulcers and Acute Aortic Syndrome
Penetrating ulcers develop when atherosclerotic lesions enter the elastic lamina in the aortic wall's media.
It's an updated version of the FDA-approved Valiant Captivia thoracic stent graft, a minimally invasive device that treats aneurysms, penetrating ulcers
and related conditions of the descending thoracic aorta.
Aortic pathologies such as aneurysms, arterial penetrating ulcers
, intramural hematomas and dissections are potentially life-threatening since the aorta is the major artery that allows blood to leave the heart.