Presentation
Patient presented with sudden severe chest and abdominal pain, absent pulse in left arm.
Patient Data
Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.
Extensive aortic dissection, seen involving ascending aorta, aortic arch, descending and abdominal aorta and seen extending into the left common iliac artery, left subclavian, proximal aspect of SMA, left renal artery and right innominate arteries.
There is non-enhancement of the Right CCA, with thrombus formation and very faint peripheral flow.
No evidence of active leaking or retroperitoneal or mediastinal hematoma.
There is attenuation of the common hepatic artery, however, there is flow within the distal branches. The distal aspect of SMA, IMA and right renal are enhancing.
Severely decreased enhancement of the left kidney, keeping with significant ischemic changes /infarction.
Multiple small bowel loops are of increased mucosal enhancement while others show severely decreased mucosal enhancement, suggesting ischemic bowel changes, no pneumatosis, no free abdominal air, no portal or SMV venous gas.
Thrombosed mid-aspect of the splenic artery, its distal aspect showing filling from collaterals, suggesting this one was not acute and it was there for some time
Thrombosed right CIA, Rt EIA, with bifemoro arterial graft anastomosis, the Right CFA is seen filled from the graft.
Case Discussion
Severe aortic dissection, DeBakey I, Stanford A, complicated by intestinal ischemia and severe left renal ischemia/infarction and thrombosis of right common carotid artery.
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