Aguilar J C
J Forensic Sci. 1979 Jul;24(3):600-7.
This paper has reported a case of sudden unexpected death in a 19-year-old man, shot in the abdomen, who was surgically treated and discharged. He died of massive left retropleural hematoma from a spontaneous rupture of a traumatic pseudo-aneurysm of the abdominal aorta. Diagnosis of the retropleural hemorrhage and the aortic pseudo-aneurysm was possible, though not made antemortem, through chest X-rays and ultrasound studies of the abdomen correlated with the patient's symptoms. Early radiologic signs of the hematoma consisted of obliteration of the aortic silhouette on the anteroposterior view and the left primary sulcus on the lateral film by a convex expanding homogenous density whose medial border blended imperceptibly with the mediastinal shadow. On ultrasound study the pseudo-aneurysm appears as semilucent midline shadow anterior to the vertebral column and related to the aorta, giving the latter an appearance of increased diameter.
本文报道了一例19岁男性腹部中弹后意外猝死的病例，该患者接受了手术治疗并出院。他死于腹主动脉创伤性假性动脉瘤自发破裂导致的大量左胸膜后血肿。尽管生前未作出诊断，但通过胸部X光和腹部超声检查并结合患者症状，有可能诊断出胸膜后出血和主动脉假性动脉瘤。血肿的早期放射学征象包括前后位片上主动脉轮廓消失，侧位片上左侧主沟被均匀密度的凸形扩张影遮盖，其内侧边界与纵隔阴影难以察觉地融合。在超声检查中，假性动脉瘤表现为脊柱前方的半透明中线阴影，与主动脉相关，使主动脉直径看起来增大。
