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La disección aguda de la aorta disfrazada de torsión testicular: un informe de caso
Bruce M Lo1, Megyn K Christensen2, Coral E Byrns2
1Sentara Norfolk General Hospital/Eastern Virginia Medical School at Old Dominion University, Department of Emergency Medicine, Norfolk, Virginia.
Clinical practice and cases in emergency medicine
|February 10, 2026
Resumen
La disección aórtica aguda (DAA) puede presentarse atípicamente, imitando condiciones como la torsión testicular. El diagnóstico rápido es crucial para esta condición potencialmente mortal, incluso con síntomas iniciales inusuales.
Área de la Ciencia:
- Cardiología Cardiología.
- Cirugía vascular Cirugía vascular.
- Medicina de emergencia Medicina de emergencia.
Sus antecedentes:
- La disección aórtica es una condición crítica con alta mortalidad si el diagnóstico se retrasa.
- Los síntomas clásicos incluyen dolor repentino en el pecho o la espalda, pero las presentaciones atípicas pueden engañar a los médicos.
- El diagnóstico tardío de la disección aórtica es una preocupación significativa en entornos de emergencia.
Objetivo del estudio:
- Para informar de un raro caso de disección aórtica aguda que se presenta inicialmente como dolor testicular.
- Para enfatizar la importancia de considerar la disección aórtica en pacientes con síntomas atípicos.
- Para resaltar los desafíos diagnósticos planteados por presentaciones poco comunes de disección aórtica.
Principales métodos:
- Un informe de caso que detalla el viaje de un paciente a través del diagnóstico y el tratamiento.
- Presentación inicial en el departamento de emergencias con síntomas que sugieren torsión testicular.
- Posterior regreso al departamento de emergencias con el empeoramiento del dolor, lo que lleva a la imagen avanzada y el diagnóstico de la disección aórtica.
Principales resultados:
- El paciente se presentó inicialmente con dolor testicular izquierdo y fue evaluado para la torsión testicular.
- La exploración quirúrgica para la torsión fue negativa; el paciente fue dado de alta.
- El paciente regresó con dolor de espalda, y la tomografía computarizada reveló una disección aórtica aguda tipo A.
- El paciente se sometió a una reparación quirúrgica y tuvo una estancia hospitalaria de 12 días.
Conclusiones:
- La disección aórtica aguda puede manifestarse con síntomas que imitan otras afecciones, como la torsión testicular.
- Los médicos deben mantener un alto índice de sospecha para la disección aórtica cuando los diagnósticos iniciales no explican completamente los síntomas del paciente.
- Este caso subraya la necesidad de diagnósticos diferenciales amplios en medicina de emergencia, especialmente para condiciones potencialmente fatales.
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