Urgent surgery was planned, but a few hours before the operation, sudden chest pain and hypotension occurred, followed by shock. After resuscitation the patient was transferred to the operating room. On exploration soon after resuscitation, there was a large aneurysm originating from the inferior wall of the aortic arch distal to origin of arch vessels. The inferior tip of the aneurysmal sac was ruptured into the left pleural cavity. Reconstruction with a Dacron patch was undertaken successfully.
Venous involvement is more common than arterial disease.
Since the first presentation of aneurysm formation in BD in 1961, there have been a growing number of reports on aneurysms in different arteries. Beh et aortitis can lead to saccular or dissecting aneurysm. Pathogenesis of the Beh et's aneurysm is thought to be obliterative endarteritis of the vasa vasorum with resultant aneurysmal dilatation. Arterial false aneurysms may also occur in BD and is therefore associated with high mortality if untreated. Surgery for arterial complications of BD is difficult due to fragile nature of the affected vessels.