A Case of Stanford Type A Acute Aortic Dissection Causing Stricture Type Ischemic Enteritis

HIRATA Masaaki, SHIRAKATA Yoshiharu

doi:10.3919/jjsa.77.2424

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Other Title

狭窄型虚血性小腸炎をきたしたStanford A型急性大動脈解離の1例
症例狭窄型虚血性小腸炎をきたしたStanford A型急性大動脈解離の1例
ショウレイキョウサクガタキョケツセイショウチョウエンオキタシタ Stanford Aガタキュウセイダイドウミャクカイリノ 1レイ

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Description

A 54-year-old man was brought into our hospital by ambulance because of the abrupt onset of back pain. Chest and abdominal CT scans revealed Stanford type A acute aortic dissection associated with dissection of the superior mesenteric artery (SMA). We emergently performed ascending aortic replacement followed by placement of a stent into the main trunk of the SMA. The patient's postoperative course was uneventful, but he developed small bowel obstruction on the 11^th day after initiation of oral ingestion. Considering that conservative treatment might be unsuccessful, we performed surgery on the 44^th day after the onset of the symptoms. During surgery, we confirmed complete obstruction of the small intestine about 170 cm proximal to the terminal ileum and performed enterectomy. Stricture type ischemic enteritis was diagnosed based on surgical and histologic findings.<BR>If the aortic dissection may involve the SMA, we have to keep a possibility of bowel necrosis in mind in its acute phase, but in the chronic phase, we have to remind that the appearance of abdominal symptoms can indicate ischemic enteritis.

Journal

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 77 (10), 2424-2428, 2016

Japan Surgical Association

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