Abstract

Introduction: An aneurysm is a localized dilatation of an artery, a vein, or the heart. Aneurysm of descending thoracic aorta usually asymptomatic and diagnosed by chance. Here we report the case of a 30-year-old man who presented to our hospital with breathlessness, cough, chest pain, whose initial chest imaging mimicked a left sided massive pleural effusion. The final diagnosis is giant aortic aneurysm with mural thrombosis. Diagnostic thoracocentesis, before computed tomography, in resource-poor settings, may have resulted in an adverse outcome in our case.

Case Presentation: A 68-year-old man was referred to us for further evaluation of a suspected left sided massive pleural effusion. His presenting symptoms are breathlessness, cough, chest pain for 2 months. His chest x-ray showed left sided massive pleural effusion. However CT scan thorax with contrast & aortogram showed giant aortic aneurysm with mural thrombus which was confirmed by echo report.

Conclusion: Thoraco-abdominal aortic aneurysm can mimic left sided pleural effusion which is reported in literature. We illustrate the importance of a high degree of suspicion of cardiovascular pathology in order to avoid an adverse outcome following diagnostic thoracentesis.

Keywords: Aortic Aneurysm, Left massive pleural effusion, mural thrombus.