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Aortic dissection : a case of atypical clinical manifestation and valuable lessons in management
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Ha, L. D. and Imray, C. (Chris) (2011) Aortic dissection : a case of atypical clinical manifestation and valuable lessons in management. BMJ Case Reports, Vol.2011 . Article no. bcr0220113801. doi:10.1136/bcr.02.2011.3801 ISSN 1757-790X.
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Official URL: http://dx.doi.org/10.1136/bcr.02.2011.3801
Abstract
A 55-year-old gentleman with a medical history of hypertension presented to emergency department with sudden onset of central abdominal pain and left flank pain. A CT KUB (kidney, ureter and bladder) was performed to assess the patient for a possible renal calculus and other potential gastrointestinal causes. However, an extensive aortic dissection from the arch of the aorta to the iliac arteries was detected. Hypotensive blood pressure control was started in an attempt to reduce the shear stress on the aortic wall. Unfortunately, the drop in blood pressure reduced splanchnic perfusion, resulting both duodenal perforation (secondary to duodenal ischaemia of the watershed area) and the development of acute renal failure. The patient underwent an emergency laparotomy for the perforated duodenum and biliary peritonitis. He was transferred to the intensive care unit for 18 days postsurgery for renal, respiratory, nutritional and cardiovascular support and was finally discharged home.
| Item Type: | Journal Article | ||||
|---|---|---|---|---|---|
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | BMJ Case Reports | ||||
| Publisher: | B M J Group | ||||
| ISSN: | 1757-790X | ||||
| Official Date: | 2011 | ||||
| Dates: |
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| Volume: | Vol.2011 | ||||
| Page Range: | Article no. bcr0220113801 | ||||
| DOI: | 10.1136/bcr.02.2011.3801 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access |
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