Abstract
We report a case of acute type I aortic dissection with ischemic enterocolitis due to blood flow insufficiency in the superior mesenteric artery. The patient was a 52-year-old man who visited the hospital with major complaints of sudden low back pain and melena. Mesenteric ischemia was suspected, and angiography revealed type I aortic dissection with accompanying blood flow insufficiency in the superior mesenteric artery. Because catheterization during angiography improved the blood flow disorder and prevented intestinal necrosis, it was possible to replace the ascending aorta with a prosthetic graft. Arterial pulsation in the mesentery was recovered by the operation and the patient’s life was saved without bowel resection. This case demonstrates that prompt surgical or percutaneous relief of ischemia in major organs is important to save lives in the cases of acute aortic dissection with ischemic complications.
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References
DeBakey ME, McCollum CH, Crawford ES, Morris GC, Howell J, Noon GP, et al. Dissection and dissecting aneurysms of the aorta: twenty-year follow-up of five hundred twenty-seven patients treated surgically. Surgery 1982; 92: 1118–34.
Okita Y, Takamoto S, Ando M, Morota T, Kawashima Y. Surgical strategies in managing organ malperfusion as a complication of aortic dissection. Eur J Cardiothorac Surg 1995; 9: 242–7.
Cambria RP, Brewster DC, Gertler J, Moncure AC, Gusberg R, Tilson MD, et al. Vascular complications associated with spontaneous aortic dissection. J Vasc Surg 1988; 7: 199–209.
Pinet F, Froment JC, Guillot M, Gourdol Y, Meyer P, Loire R, et al. Prognostic factors and indications for surgical treatment of acute aortic dissections: A report based on 191 observations. Cardiovasc Intervent Radiol 1984; 7: 257–66.
Miller DC, Mitchell RS, Oyer PE, Stinson EB, Jamieson SW, Shumway NE. Independent determinants of operative mortality for patients with aortic dissections. Circulation 1984; 70 (Suppl I): I–153-64.
Kazui T, Kimura N, Yamada O, Komatsu S. Total arch graft replacement in patients with acute type A aortic dissection. Ann Thorac Surg 1994; 58: 1462–8.
Leslie BR, Head LH, Scharfenberg JC. Ischemic hepatitis from aortic dissection. Ann Int Med 1989; 110: 495.
Williams DM, Brothers TE, Messina LM. Relief of mesenteric ischemia in type III aortic dissection with percutaneous fenestration of the aortic septum. Radiology 1990; 174: 450–2.
Slonim SM, Nyman U, Semba CP, Miller DC, Mitchell RS, Dake MD. Aortic dissection: percutaneous management of ischemic complications with endovascular stents and balloon fenestration. J Vasc Surg 1996; 23: 241–53.
Slonim SM, Nyman UR, Semba CP, Miller DC, Mitchell RS, Dake MD. True lumen obliteration in complicated aortic dissection: endovascular treatment. Radiology 1996; 201: 161–6.
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Ninomiya, M., Makuuchi, H., Naruse, Y. et al. Type I acute aortic dissection accompanied by ischemic enterocolitis due to blood flow insufficiency in the superior mesenteric artery. Jpn J Thorac Caridovasc Surg 47, 465–469 (1999). https://doi.org/10.1007/BF03218045
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DOI: https://doi.org/10.1007/BF03218045