Penetrating Aortic Ulcer – ACR 2013

Annual follow-up is recommended when asymptomatic and more frequent follow-up if symptoms arise, with consideration of surgical or endovascular intervention.

• “Penetrating aortic ulcers (PAUs) represent disruption of atherosclerotic plaque with penetration of luminal blood for variable distances into or through the aortic wall.”
• “They may present with acute symptoms and findings, but they may also be recognized as chronic, asymptomatic, incidental findings.”
• “Studies have shown that the natural history of PAU is variable, unpredictable, and may be one of progressive enlargement resulting in rupture.”

Reference: Khosa F, Krinsky G, Macari M, Yucel EK, Berland LL. Managing Incidental Findings on Abdominal and Pelvic CT and MRI, Part 2: White Paper of the ACR Incidental Findings Committee II on Vascular Findings. J Am Coll Radiol 2013;10:789-794.