A Giant Pseudo Aneurysm Of The Left Ventricle Revealed By Hematemesis.

A pseudo aneurysm due to the rupture of myocardium can occur after trauma, infarction, cardiac surgery or bacterial endocarditis. This false aneurysm has a high morbidity, a risk of spontaneous rupture and sudden death. We report a case of a left ventricular pseudo aneurysm in a 14-year-old male patient with past medical history of chest blunt trauma associated with a distal lower humerus fracture treated in 2005. He was admitted for moderate hematemesis associated with left upper quadrant and flank pain and dyspnea on exertion. The physical examination revealed a tender mass extending from the epigastrium to the left flank. Gastro esophageal duodenal endoscopy revealed a bleeding ulcer Forrest class IIb in the posterior wall of the fundus. The aneurysm first seen in the CT scan was confirmed by MRI which displayed the presence of a pseudo aneurysm of the left ventricle ruptured in the apex in a loculated pericardium. As soon as the diagnosis of left ventricle pseudo aneurysm was confirmed, the patient was sent to the cardiovascular surgery department where he underwent aneurysmectomy under extracorporeal circulation. The postoperative course was characterized by a hemodynamic instability. He died two days later of cardiogenic shock. In the face of any chest trauma even blunt trauma, an exploration by echocardiography or chest CT scan is desirable to detect this complication in time in order to improving the prognosis of patients with large and complicated aneurysms.