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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The DeBakey classification divides type A acute aortic dissection (AAD) into type I and type II; the latter limited to the ascending aorta. We endeavored to examine differences in DeBakey groups in a contemporary registry. We divided 1,872 patients with noniatrogenic AAD from the International Registry of Acute Aortic Dissection into type I (n = 1691, 90.3%) and type II (n = 181, 9.7%). Patients with type II AAD were older. On presentation, patients with type I AAD reported more back and abdominal pain and were more likely to have pulse deficit. Intramural hematoma was more frequent in type II AAD. Most patients with both types were treated surgically. Lower rates of renal failure, coma, mesenteric and limb ischemia were noted in those with type II AAD. In-hospital death was less frequent (16.6% vs 22.5%) after type II AAD, a trend that did not reach significance. There was no difference in the incidence of new dissection, rapid aortic growth, late aortic intervention or survival at 5 years. In conclusion, AAD limited to the ascending aorta (DeBakey type II) appears to be associated with improved clinical outcomes compared with dissection that extend to the aortic arch or beyond. Although fewer dissection-related complications were noted in patients presenting with type II AAD, as was a trend toward reduced in-hospital mortality, 5-year survival and descending aortic sequelae are not reduced in this contemporary report from International Registry of Acute Aortic Dissection.
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PMID:Comparison of Outcomes in DeBakey Type AI Versus AII Aortic Dissection. 2997 Feb 40

Aortic dissection is a severe condition that involves a tear in the wall of the major artery carrying blood out of the heart (aorta). This cardiac disease has a high mortality, particularly Stanford type A, which involves the first part of the aorta. Aortic dissection is characterized by urgent onset, rapid progress, and poor outcome [Nienaber 2003; Mehta 2002]. Surgery is the most effective treatment. Although there have been remarkable recent advances in the understanding and management of various aspects of these complex surgeries, many potential complications remain. Non-traumatic splenic rupture is a rare postoperative complication of type A aortic dissection, and there are only a few published reports discussing this complication. Splenic rupture is a life-threatening cause of intraperitoneal bleeding and often is associated with the preexisting pathology of the spleen in the absence of trauma [Renzulli 2009]. Its manifestation is characterized by abdominal pain, left shoulder pain, and even shock. Because of the history of aortic dissection, physicians initially may suspect arterial rupture. In our report, we aim to present the possibility of splenic rupture as a complication of aortic dissection surgery and the need for immediate surgical intervention.
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PMID:Non-Traumatic Splenic Rupture After Open Surgery for Type A Aortic Dissection: A Case Report and Literature Review. 3252 90

Aortic dissection originates from isolated tear in the abdominal aorta is rare but potentially life or limb-threatening condition particularly if misdiagnosed. It may have a number of clinical presentations with potentially serious adverse effects and should be considered in the differential diagnosis of any patient with an acute onset of abdominal pain radiating to the back and the buttocks together with presence or absence of a pulsatile abdominal mass, signs of limb ischemia, or discernible risk factors. Surgical and endovascular treatments are two valid options for these cases according to their clinical and anatomical considerations with acceptable results. We present a quite unusual case of a spontaneous supraceliac isolated abdominal aortic dissection with contained peri-aortic hematoma and manifesting as acute persistent abdominal pain. Better illustration of the natural history of this ill-defined pathology is needed to understand and improve patient care.
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PMID:Endovascular treatment for spontaneous supraceliac isolated abdominal aortic dissection is a fabulous option. (Case report). 3304 48


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