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Aortic dissection masquerading as gastrointestinal disease.

H P Nath, P F Jaques, B Soto

    Cardiovascular and Interventional Radiology
    |January 1, 1986
    PubMed
    Summary
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    Aortic dissection (AD) can present with gastrointestinal bleeding, a rare but serious symptom. Consider AD in patients with unexplained GI hemorrhage, as it may mimic other conditions.

    Area of Science:

    • Cardiovascular Medicine
    • Gastroenterology
    • Diagnostic Imaging

    Background:

    • Aortic dissection (AD) commonly presents with chest or abdominal pain.
    • Gastrointestinal (GI) symptoms, apart from abdominal pain, are infrequent in AD presentations.

    Observation:

    • Two cases of AD are presented where GI hemorrhage was the primary symptom.
    • One patient had acute Type I dissection with mesenteric infarction, mimicking ulcerative colitis.
    • Another patient had an old Type III AD causing a retroperitoneal false aneurysm that ruptured into the duodenum.

    Findings:

    • Mesenteric infarction in AD can present with symptoms similar to inflammatory bowel disease.
    • Rupture of AD-associated aneurysms into the GI tract can cause severe hemorrhage.

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  • Diagnostic limitations, such as limited angiography, can lead to missed or delayed AD diagnosis.

    • Implications:

    • Clinicians should consider aortic dissection in the differential diagnosis of acute GI bleeding.
    • Enhanced awareness of rare AD presentations can improve diagnostic accuracy.
    • Comprehensive vascular imaging is crucial for diagnosing complex aortic pathologies.