A 62 year old hypertensive man was admitted with acute back pain radiating to the abdomen and right leg. Examination revealed cardiac enlargement, BP 210/100 mm Hg and a reduced right femoral pulse. Death occurred rapidly.
The specimen comprises 3 transverse sections of aorta and one of right iliac artery. In each, the media has been widely split and blood clot lies within the dissecting aneurism. The aortic intima is atheromatous. This is a dissecting aortic aneurism. The intima of the proximal descending aorta was torn at post mortem.