Document Detail


Acute aortic dissection presenting with primarily abdominal pain: a rare manifestation of a deadly disease.
MedLine Citation:
PMID:  15735946     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of this study was to determine the morbidity and mortality of patients with acute thoracic aortic dissections who present primarily with abdominal pain. Nine hundred ninety-two patients (mean age, 62.1 years +/- 14.1; 68% male) encountered from 1996 to 2001 with acute thoracic aortic dissections from the International Registry of acute Aortic Dissection were studied. Patient demographics, presenting symptoms, signs of aortic dissection, aortic pathology, and mortality were compared in patients presenting primarily with abdominal pain (group I, 46 patients, 4.6%) versus all others (group II). Demographics were similar between the two groups. When signs of aortic dissection were examined, 63% of patients in group I presented with hypertension compared to only 47% of patients in group II (p = 0.04). Patients in group I were less likely to present with evidence of end-organ malperfusion. Importantly, mortality in patients with a type B dissection, specifically following surgery for the dissection, was significantly increased in patients who presented primarily with abdominal pain (group I, 28% mortality vs. group II, 10.2% mortality; p = 0.02). This study documented increased mortality in patients with acute thoracic aortic dissections who present primarily with abdominal pain, underscoring the importance of maintaining a high index of suspicion for an aortic dissection in patients who have appropriate risk factors.
Authors:
Gilbert R Upchurch; Christoph Nienaber; Rossella Fattori; Arturo Evangelista; Jae Oh; Jeanna V Cooper; Eric Isselbacher; Toru Suzuki; Kim A Eagle;
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of vascular surgery     Volume:  19     ISSN:  0890-5096     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-05-25     Completed Date:  2005-08-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  367-73     Citation Subset:  IM    
Affiliation:
University of Michigan Health System, Ann Arbor, MI 48109-0329, USA. riversu@umich.edu
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MeSH Terms
Descriptor/Qualifier:
Abdominal Pain / etiology*
Acute Disease
Aged
Aneurysm, Dissecting / complications*,  mortality,  surgery
Aortic Aneurysm, Thoracic / complications*,  mortality,  surgery
Female
Hospital Mortality
Humans
Male
Middle Aged
Survival Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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