mm
in the
the
Examination of
left
Introduction
Hg
palpe-
anemia,
No
leg.
bral
and the
showed no evidence of
was not
conjunctiva
bulbus
conjunctiva
yellow.
that
It
become
there are
abnormalities
detected on
has
were
recently
apparent
cardiopulmonary
ofaortic
one ofwhichis aor-
auscultation. The abdomenwas
and
and
flat
dissection,
tic dissection without false lumen.
aortic intramural
soft,
subtypes
This has been
a
no
masswas evident. Noedemawas ob-
palpable
in
referred
aortic
served
the lower
and the
to as
limbs,
hemorrhage, 1-6
neurologic
intimal
without
and
were normal.
dissection
rupture, l2
findings
aortic dissection.7,8 Much
about the mechanism of the
of aortic dissection. Further-
andblood chemical
examination
elevated white
and creatine
early thrombosed-type
Hematologic
remains unknown
on admission showed
blood cell count
a
slightly
x
of this
onset
(10.5
type
103/AL)
there is nouniformtermto describe it. The
more,
(611 IU/L).
phosphokinase activity
Emergency
natural
lumen
section
ofaortic dissection without
to differ from that of aortic dis-
false lumen.6Aortic dissection with
a
false
contrast CTshowed
of the true lumen
history
narrowing
and the formation of
a
false lumenin the ascend-
appears
with
a
and
aorta
The di-
with
non-
left).
1,
ing
agnosis
descending
a
(Figure
a
false lumen and aortic intramural
of Stanford type Aaortic dissection
hemorrhage
types
are
treated as different
of aortic
a
false lumenwas
made. The
presently
following
day,
dissection.
of the
contrast CTrevealed increased
aortic wall. Contrast CTshowed resolution ofthe
brightness
There have been recent
of transition
reports
ofaortic dissection in
to
the false-lumen
false lumen centered around the
The
aorta
of
type
pa-
ascending
tients with aortic
treated
intramural hemorrhage.9,10 We
CTfindings were
typical
1,
(Figure
right).
a
in whomthe reverse occurred.
aortic
tial
the ini-
Stanford
intramural
patient
hemorrhage. Although
the
was
as
on admissionwas that of
a
admission,
Upon
patient
diagnosed
diagnosis
aortic
with
dissection
a
false
A
aortic
the false lumen soon be-
lumen; but,
the
false lumen
onset,
dissection,
having
type
came
a
short time after
occluded. The
his back
were
blood
sta-
resolved,
patient’s
pressure
and the
on
and no
other or-
(CT)
findings
computed tomography
bilized,
gans
fore decided to
with
resolved,
pain
resembled
of
intramural hemor-
those
the dissection.
the
Wethere-
closely
damaged by
This
is of interest when
consider-
rhage.
patient
manage
patient medically,
the
ing
of aortic intramural hemor-
treatment aimed
at
the
pathogenesis
principally
reducing
and the
with
aortic
between
dis-
blood
rhage
relationship
a
pressure.
section
false lumen and aortic intramural
the
CTon
27th
Follow-up
dayof hospitaliza-
tion
true lumen and
revealed the
of
left)
2,
hemorrhage.
(Figure
narrowing
of the aortic wall ac-
thickening
thrombotic occlusion
aorta.
of the false
There was no di-
companied by
lumenin the
Case
Report
descending
A64-year-old
man
with chest andback
for
earlier but had no
latation of the
aorta or enhancement
were
presented
ascending
of the false lumen.
He had been
Oral
pain.
hospitalized
paroxysmal
antihypertensives
atrial
fibrillation
1
and rehabilitation was initiated. The
started,
year
history
pa-
45
of
tient
Onthe
of
the
pa-
tient made
andwas
admission,
hypertension.
day
good
progress
discharged
a
in his back imme-
of stairs in his
after admission. Five months after
CT showed resolution of the
experienced sharp pain
days
presen-
after
a
diately
tation,
walking
flight
up
could
narrowing
home. Theback
he was
and
notbe
of the true
thrombotic
occlusion ’
lumen and
controlled,
emergency
aortic
dissec-
pain
ambulance to the
2,
brought by
(Figure
right).
of our
Acute
department
hospital.
tion was
after CT of the chest and ab-
diagnosed
domen
lumen
celiac
a
demonstrated
circumferential false
’
from the
aorta to the
the
extending
ascending
On
.
Discussion
examination,
68
artery origin.
patient
was
cm tall and
of
He had
a
172
weighed
kg.
60
rate of
a
36.6°C,
temperature
per
Hg
arm,
regular pulse
and blood
of
mm
the left
150/80
Onthe second
of
CTshowed
of aortic intramural hem-
150/80
minute,
pressures
day
hospitalization,
in the
mm
in
characteristic
148/76
arm,
right
Hg
findings
orrhage.
mm
in the
and
If
not been
on
seen
the
had
false lumen
152/82
Hg
right leg,
972