Spontaneous isolated dissection of the abdominal aorta: single-center experience

Isolated abdominal aortic dissection is a rare clinical entity. We report a single-center experience with six patients with acute isolated abdominal aortic dissection managed during a period of seven years. The patients' median age was 62 years and they were predominantly male. All patients presented acutely with abdominal pain, one with hypovolemic shock due to aortic rupture, two with acute lower limb ischemia and one with buttock necrosis. Interestingly, one major symptom was astasia observed in four patients that resolved postoperatively. Computed tomography scan of the thoracic and abdominal aorta was the main diagnostic tool in all patients. Treatment consisted of open repair in three cases and endovascular repair with stent-graft deployment in the remaining three patients. One patient died postoperatively from multiorgan failure. Although natural history and treatment strategies of isolated abdominal aortic dissection have not been well defined, accurate clinical diagnosis and prompt management are essential to prevent adverse complications. Moreover, sudden development of astasia should alert the physician about this pathologic entity.