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Thoracic aortic dissection

Case contributed by Ian Bickle
Diagnosis certain

Presentation

20 year-old with acute chest pain. No past medical history.

Patient Data

Age: 20
Gender: Male
ct

Dilatation of the descending aorta, commencing at the level of the arch.

A dissection flap is evident with a 'tennis ball' type appearance of the smaller true and larger false lumen.

Retro-esophageal origin of the right subclavian artery, with its origin at the same level on the arch as the dissection.

Case Discussion

The typical appearances of a thoracic dissection in the first choice investigation of a contrast enhanced CT chest.

This represents a Stanford Type B dissection, given it commences distal to the origin of the left subclavian artery.

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