Acute aortic dissection with intestinal ischemia: what to do first
| Autor: | Paola Tramelli, P. Gramigna, Alessia Alloni, Francesco Meriggi, Mario Viganò |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Time Factors medicine.medical_treatment Peritonitis Aortography Blood Vessel Prosthesis Implantation Necrosis Aneurysm Ischemia medicine.artery medicine Humans Laparoscopy Colectomy Aortic dissection Abdomen Acute Aorta medicine.diagnostic_test business.industry Gastroenterology General Medicine medicine.disease Surgery Aortic Aneurysm Intestines Aortic Dissection medicine.anatomical_structure Treatment Outcome Acute abdomen Acute Disease Abdomen medicine.symptom Cardiology and Cardiovascular Medicine business Tomography X-Ray Computed Abdominal surgery |
| Zdroj: | Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia. 17(6) |
| ISSN: | 2186-1005 |
| Popis: | Purpose: In the case of an acute aortic dissection, a surgical aortic procedure is usually the priority in order to restore the perfusion of vital organs. Afterwards, associated ischemic abdominal visceral lesions can be resected. For particular patients, it could be highly beneficial to perform the abdominal surgery before surgically addressing the aorta. The aim of this paper is to contribute to the therapeutic choice in cases of acute aortic dissection with acute abdomen.Case report: The case is reported of a 38-year-old patient, affected by an acute aortic dissection (Stanford type A) and peritonitis.Suspecting the necessity for a complex combined surgical procedure, the patient underwent emergency diagnostic laparoscopy, which showed an infarctual necrosis of the distal ileum and right colon. Therefore, he immediately underwent a wide right hemicolectomy. Afterwards, an ascending aortic substitution was performed.The patient was discharged on the 15th post-operative day, and he is doing well, 1 year and 3 months after the operation.Conclusion: In the case of an acute aortic dissection with acute abdomen, emergency laparoscopy is a precious surgical technique to identify criteria that can lead to therapeutic decisions, including timing. |
| Databáze: | OpenAIRE |
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