Pseudoaortic dissection

Am J Emerg Med. 2012 Jul;30(6):1011.e5-6. doi: 10.1016/j.ajem.2011.03.023. Epub 2011 Jun 8.

Abstract

A 72-year-old man was brought to our emergency department (ED) because of upper abdominal pain. Initial vitals at the triage station were significant only for high blood pressure. Computed tomography (CT) of the abdomen with contrast enhancement revealed an intimal flap over his descending aorta, the infrarenal part. The flap was found throughout the descending aorta until its bifurcation. Stanford type B dissection was initially suspected. However, a reconstructed CT discovered an interesting feature of the aorta. A high aortic bifurcation at the level of the second lumbar vertebrae, in conjunction with bilateral common iliac arteries, appeared in pair, masquerading the CT image as infrarenal aortic dissection. Actually, that was a variant in human anatomy. A reconstructed sagittal view of the CT scan is mandatory for a patient with abdomen pain to avoid misinterpretation of the radiographic image.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Aged
  • Aorta, Thoracic / abnormalities*
  • Aorta, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Abdominal / diagnosis*
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Dissection / diagnosis*
  • Aortic Dissection / diagnostic imaging
  • Diagnosis, Differential
  • Emergency Service, Hospital
  • Humans
  • Male
  • Tomography, X-Ray Computed
  • Ultrasonography