At the moment of admittance, his vital signs were: blood pressure 130/80 mmHg, heart rate of 92, respiratory rate of 12, body temperature of 36.6 ☌. Therefore he is taken to a public third level hospital in order to continue tests. Hence, he attends a private clinic where he gets an abdominal CT scan showing a dilation of the infrarenal abdominal aorta. Clinical caseĪ 74-year-old man with a history of systemic high blood pressure and benign prostatic hyperplasia in treatment begins his illness 24 h prior to his hospital admission with sudden and intense lumbar and abdominal pain. 3 Hereunder we report a case of primary dissection of the abdominal aorta, its clinical presentation and a review of the literature about this pathology. The latter is the technique of choice for open surgery. Strategies for its treatment are conservative for asymptomatic cases with a non-dilated aorta, and for symptomatic patients, repair through the placement of a stent. Natural history and treatment options are not well established its description in the literature is mainly based on case reports and series with a few cases. Its clinical presentation may be either acute with a sudden onset of the symptoms, or chronic (over 14 days). 2 Causes of dissection may be spontaneous, traumatic or iatrogenic. 1 The mean frequency reported for primary dissection of the abdominal aorta is less than 2%, compared with that of the ascending aorta (70%), the descending aorta (20%), and the aortic arch (7%). This catastrophic process sometimes involves the thoracic aorta thus, a limited dissection of the abdominal aorta is rare. See more Open Access OptionĪortic dissection occurs when the layers of the aortic wall separate as the result of an entrance of blood through a tear in the intima. Se fomenta el escrito médico sin relación con la ciencia: anécdotas, historias y relatos de médicos y pacientes. La revista pretende apoyar a las ciencias medicobiológicas relacionadas con la salud y tener un espacio para la historia, la filosofía y la ética. Medical writing without relation to science is promoted: anecdotes, stories and short stories of doctors and patients.ĭirigida a estudiantes y docentes de la Facultad de Medicina de la Universidad Autónoma de Nuevo León, la revista Medicina Universitaria busca fomentar el escrito medico-científico y con ello apoyar la investigación y la creatividad en la medicina. The journal aims as well to support the medical-biological sciences related to health as to have a space for history, philosophy and ethics. It seeks to promote medical-scientific writing and thereby support research and creativity in Medicine. A small subgroup of type A IMH patients are managed medically and have a significant in-hospital mortality.The journal Medicina Universitaria is aimed at students and teachers of the School of Medicine of the Universidad Autónoma de Nuevo León. Patients with IMH have a mortality that does not differ statistically from those with classic AD. One-year mortality was not significantly different between AD and IMH.Īcute IMH has similar presentation to classic AD but is more frequently complicated with pericardial effusions and periaortic hematoma. Patients with type B IMH had a hospital mortality that was less but did not differ significantly (4.4% versus 11.1% P=0.062) from classic AD. Overall in-hospital mortality was not statistically different for type A IMH compared to AD (26.6% versus 26.5% P=0.998) type A IMH managed medically had significant mortality (40.0%), although less than classic AD (61.8% P=0.195). Although type A IMH and AD were managed medically infrequently, type B IMH were more frequently treated medically. ![]() Patients with type A IMH were less likely to present with aortic regurgitation or pulse deficits and were more likely to have periaortic hematoma and pericardial effusion. Patients with IMH were older and presented with similar symptoms, such as severe pain. Of 2830 patients, 178 had IMH (64 type A, 90 type B, and 24 arch). Patients with acute aortic syndromes in the International Registry of Acute Aortic Dissection (1996-2011) were evaluated to examine differences between patients (based on the initial imaging test) with IMH or classic dissection (AD). Acute aortic intramural hematoma (IMH) is an important subgroup of aortic dissection, and controversy surrounds appropriate management.
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