Acute Type B Aortic Dissection Presenting as Acute Abdomen

Liang-Ying Ke, Hong-Jie Jhou,

Abstract

This report presents a surgical repair of a complicated acute type B aortic dissection in a 42-year-old male who suffering from acute abdominal pain initially and the postoperative course was complicated with chylothorax. Acute aortic dissection is a life-threatening vascular emergency and the anterior chest pain radiating to the back is the typical pattern when it attacks suddenly. However, epigastralgia or diffused abdominal pain could be experienced when abdominal branch vessels were involved. Here, we review the literature on acute aortic dissections complicated by involvement of abdominal branch vessels, causing visceral malperfusion or mesenteric ischemia. Vital organ malperfuion, including major cerebral malperfusion, coronary malperfusion and mesenteric ischemia, have been identified as independent risk of in-hospital mortality in several large study enrollments. Despite it still remains debates of strategic and therapeutic options to correct these defects, in-time evaluations and proper examinations should be performed promptly to lower the misdiagnosis rate and reduce the extremely high in-hospital mortality.