Fatal traumatic rupture of ascending aortic aneurysm having idiopathic cystic medial necrosis: An autopsy case.

ABSTRACT

This report describes an autopsy case pertaining to death due to traumatic rupture of aortic aneurysm. A 21 year old deaf and dumb male was assaulted with kicks over the chest. Autopsy revealed external injuries over the body. Internally, a fusiform aneurysmal dilatation of the lumen of the aortic root and tubular segment of the ascending aorta were observed, with tear of the anterior wall of the ascending aorta and resultant haemopericardium. Histologically, the wall of the aneurysm revealed cystic medial necrosis, which appears to idiopathic in nature. A Common complication of aortic aneurysms is dissection, with subsequent spontaneous rupture. In this case, there was no evidence of dissection and the rupture was traumatic in nature. Death was certified as due to cardiac tamponade. The extent of trauma to which the victim was subjected to, appears to be such as would have been insufficient to cause death in an otherwise normal individual. An account of the findings, along with a discussion of the pathology of aneurysms and cystic medial necrosis as also of the mechanism of rupture of aneurysms is provided.