[A case of visceral ischemia associated with acute type IIIb aortic dissection]

The case was a 61-year-old man who was transported to our hospital with complaining of severe chest and back pain of sudden onset and diagnosed as acute type IIIb aortic dissection. Inspite of intensive medical treatments, severe abdominal pain with abdominal distension and progressive metabolic acidosis appeared at around 11 hours after admission. Aortogram revealed obstruction of both superior and inferior mesenteric arteries suggesting visceral ischemia associated with acute type IIIb aortic dissection. Emergent operation consisting of bypass grafting for the superior and the inferior mesenteric arteries with saphenous vein, partial resection of small intestine, left hemicolectomy and construction of artificial anus was immediately carried out. The patient had no particular trouble after the operation and returned to the previous job.