Solution to Unknown Case #33 – Ductus Bump or Ductus Diverticulum

History: male involved in high speed motor vehicle accident with chest pain. This is a good example of a ductus diverticulum, or ductus bump. A ductus diverticulum is a focal smooth outpouching of the aortic wall at the aortic isthmus where the obliterated ductus arteriosus (the ligamentum arteriosum) is attached to the aorta. The ductus…

radiologypics

March 30, 2013

1–2 minutes

chest, chest pain, solutions, vascular

History: male involved in high speed motor vehicle accident with chest pain.

Ductus Diverticulum - Axial CT scan of the chest with intravenous contrast reveals a focal outpouching of the descending aorta at the aortic isthmus (yellow arrow), compatible with a ductus diverticulum or ductus bump. — **Ductus Diverticulum** – Axial CT scan of the chest with intravenous contrast reveals a focal outpouching of the descending aorta at the aortic isthmus (yellow arrow), compatible with a ductus diverticulum or ductus bump.

Ductus Diverticulum - Sagittal CT of the chest with intravenous contrast reveals a focal outpouching of the aorta at the aortic isthmus (yellow arrow), representing a ductus bump or ductus diverticulum. — **Ductus Diverticulum** – Sagittal CT scan of the chest with intravenous contrast reveals a focal outpouching of the aorta at the aortic isthmus (yellow arrow), representing a ductus bump or ductus diverticulum.

This is a good example of a ductus diverticulum, or ductus bump. A ductus diverticulum is a focal smooth outpouching of the aortic wall at the aortic isthmus where the obliterated ductus arteriosus (the ligamentum arteriosum) is attached to the aorta. The ductus diverticulum is a normal finding and is present in approximately 9% of adults on aortograms. It is a mimicker of post-traumatic pseudoaneurysms which classically happen in high speed motor vehicle accidents. The differential diagnosis for this appearance includes a ductus diverticulum, a psuedoaneurysm, ulcerated atherosclerotic plaque, a diverticulum of Kommerell, and a true atherosclerotic aneurysm.

An excellent article explaining aortic wall abnormalities can be found here.

Thanks to Justin Tan, M.D. for this great example of a ductus diverticulum.