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Intimo-intimal intussusception: a rare clinical form of aortic dissection
G Touati1, D Carmi, F Trojette
1Service de Chirurgie Cardiaque, Hôpital Sud CHU Amiens, 80054 Amiens Cedex 01, France. gtouati.hms@invivo.edu
Summary
A rare aortic intussusception, a type of aortic dissection, can be missed due to the absence of an intimal tear in the ascending aorta. This condition requires careful diagnosis to avoid delays in treatment.
Area of Science:
- Cardiology
- Vascular Surgery
- Diagnostic Imaging
Background:
- Aortic dissection is a life-threatening condition involving a tear in the aorta's inner layer.
- Type I dissection involves the ascending aorta and aortic arch.
- Early and accurate diagnosis is critical for patient outcomes.
Observation:
- A 33-year-old hypertensive male presented with epigastric pain radiating to the back.
- Transesophageal echocardiography (TOE) showed an intimal flap in the aortic arch and descending aorta.
- CT and TOE did not reveal an intimal flap in the ascending aorta.
Findings:
- Post-mortem examination revealed complete circumferential dissection of the ascending aorta.
- The dissection extended to the coronary ostia.
- Intimo-intimal glove-finger intussusception of the internal channel into the descending thoracic aorta was observed.
- This represents a rare variant of Type I aortic dissection.
Implications:
- The absence of a visible intimal tear in the ascending aorta can be a misleading diagnostic feature.
- This can lead to delayed diagnosis and treatment of aortic dissection.
- Awareness of aortic intussusception is crucial for clinicians managing suspected aortic dissections.