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Stanford type A aortic dissection

Case contributed by Bahman Rasuli
Diagnosis certain

Presentation

Acute abdominal pain. History of left renal mass resection a month ago.

Patient Data

Age: 55 years
Gender: Female

Extensive dissection of the thoracoabdominal aorta involving a left-sided aortic arch with an aberrant right subclavian artery originating from Kommerell's diverticulum.

Extension of the dissection into the aberrant right subclavian artery and left common iliac artery is noted.

The true lumen is the origin of the celiac trunk, SMA, and right renal artery.

The false lumen is the origin of the left renal artery.

Thrombus formation within the false lumen of the thoracic aorta.

Case Discussion

Stanford type A acute aortic dissection with an entry at the Kommerell's diverticulum. 

True lumen in aorta dissection is smaller than the false lumen, surrounded by calcifications, and usually is the origin of celiac, SMA, and right renal artery however thrombus material always is seen in the false lumen and enhances later than the true lumen.

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