Acute aortic dissection with intestinal ischemia: What to do first

Francesco Meriggi, Alessia Alloni, Paolo Gramigna, Paola Tramelli, Mario Vigano

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)631-633
Number of pages3
JournalAnnals of Thoracic and Cardiovascular Surgery
Volume17
Issue number6
DOIs
Publication statusPublished - 2011

Keywords

  • Aortic dissection
  • Intestinal malperfusion
  • Laparoscopy

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Gastroenterology

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