Necrotizing aortitis with rupture is a rare complication of radiation of mediastinal structure. To our knowledge, this is the first electron microscopic study of radiation changes of the aorta. Collagen fibers were preserved, but there was slit-like irregular fragmentation of elastic fibers. Marcias-Rojas and Castro1 previously reported five cases of postradiation rupture of the aorta, all associated with mediastinitis. Our patient had an empyema. It is postulated that infection combined with radiation necrosis may have triggered the rupture.
Poon TP, Kanshepolsky J, Tchertkoff V. Rupture of the Aorta Due to Radiation Injury: Report of a Case and Electron Microscopic Study. JAMA. 1968;205(12):875–878. doi:10.1001/jama.1968.03140380079023
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