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Atypical presentation of type B aortic dissection mimicking appendicitis managed medically
Muhammad Azharuddin1, Maria Amanda Delacruz1, Derek Baughman2
1Internal Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA.
BMJ Case Reports
|July 2, 2018
Summary
Aortic dissection, a life-threatening condition, was diagnosed in a hypertensive patient presenting with abdominal pain. Prompt management of blood pressure was crucial for his recovery.
Area of Science:
- Cardiology
- Vascular Surgery
- Diagnostic Imaging
Background:
- Hypertension is a significant risk factor for aortic dissection.
- Aortic dissection is a medical emergency requiring prompt diagnosis and management.
- Right lower quadrant pain can be an atypical presentation of aortic dissection.
Observation:
- A 53-year-old male with hypertension presented with sudden right lower quadrant pain.
- Imaging revealed descending aortic dissection without rupture, sparing the ascending aorta and aortic arch.
- Mild renal artery stenosis was noted on ultrasound Doppler.
Findings:
- The patient's abdominal pain and leg pain resolved with blood pressure management.
- Renal function initially worsened after medication adjustments, necessitating further changes.
- The patient tolerated oral antihypertensive medications well at follow-up.
Implications:
- This case highlights the importance of considering aortic dissection in patients with atypical presentations.
- Effective blood pressure control is paramount in managing aortic dissection.
- Multidisciplinary collaboration is essential for optimal patient outcomes in complex vascular emergencies.
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