Type A aortic dissection
Sudden onset central crushing chest pain. Associated with loss of power in the legs and faecal incontinence.
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Type A aortic dissection extends from the coronary sinus to at least the external iliac vessels bilaterally, although the termination of the flap is incompletely imaged. The dissection extends into the celiac trunk, although the coronary, arch and remaining major abdominal branches arise from the false lumen. Several lumbar arteries are noted to arise from the false lumen.
Aortic dissection can be classified by either the Stanford classification or Debakey classification to risk stratify the need for surgery. Given the involvement of the ascending and descending aorta this case is a Stanford type A and Debakey type I. This place him in the high risk group and was sent for surgery soon after.