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Type B aortic dissection with early presentation mimicking acute pyelonephritis.
Chang-Chyi Jenq1, Yung-Chang Chen, Jeng-Yi Huang
1Department of Nephrology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan.
Journal of Nephrology
|July 29, 2006
Summary
A rare case of type B aortic dissection mimicked acute pyelonephritis, delaying diagnosis. Prompt recognition and surgical intervention are vital for visceral organ ischemia to improve patient outcomes.
Area of Science:
- Cardiovascular Surgery
- Nephrology
- Gastroenterology
Background:
- Aortic dissection is a critical condition necessitating prompt diagnosis and management.
- Unusual initial symptoms can impede timely diagnosis of aortic dissection.
Observation:
- A 44-year-old woman presented with symptoms suggestive of acute pyelonephritis, including flank pain, fever, and urinary abnormalities.
- Further deterioration revealed severe abdominal pain, nausea, vomiting, and declining renal function, indicative of a more complex condition.
Findings:
- Abdominal CT scan confirmed type B aortic dissection with complications including small bowel infarct, ischemic ascending colon, and left renal infarct.
- Emergency surgery was performed for bowel resection and reconstruction, followed by a second laparotomy for anastomosis leakage.
- The patient ultimately succumbed to septic shock and multiorgan failure.
Implications:
- This case highlights the rare but critical presentation of aortic dissection mimicking acute pyelonephritis.
- Emphasizes the importance of considering aortic dissection in patients with atypical presentations.
- Early surgical management of associated visceral organ ischemia is crucial for reducing mortality and morbidity.