![]() Type III has the first entry in the descending aorta and propagates distally above (type IIIa) or below (type IIIb) the diaphragm. Type II has the first entry in the ascending aorta and does not propagate to the aortic arch. ![]() Type I has the first entry in the ascending aorta and propagates distally to the descending aorta. The DeBakey system is classified into three types (types I, II, and III) according to the location of the first entry of dissection. Two classifications are most commonly used for aortic dissection. Penetrating ulcer (PU) refers to an ulcerating atherosclerotic lesion that penetrates the elastic lamina and is associated with hematoma formation within the media of the aortic wall. Aortic dissection (AD) is a tear in the inner layer of aortic wall generating an intimal flap formation, which allows blood to enter into the aortic wall, creating a new passage for blood called false lumen differentiated from the true lumen (also called aortic channel) by a flap. This generates a tear of the vasa vasorum, which is also known as aortic dissection without intimal flap formation. Intramural hematoma (IH) is a hemorrhage that affects the media layer of the aortic wall. Īortic dissection is included in the Acute Aortic Syndrome (AAS), along with intramuralhematoma and penetrating ulcer 1. The new formed channel shows flow in its intervention that returns distally to the light of the vessel through the re-entry hole. IntroductionĪcute aortic dissection is caused by the rupture of the intima that causes blood to enter the aortic wall separating the middle layers, thus forming a defined false duct between the outer middle layer and the adventitia outside and the intimate complex, medial or "flap" inside. The patient was initially diagnosed with pericardial blood vessel following an emergency eco-cardio test and a CT scan, which was immediately performed to discard aortic dissection. In the emergency department, she had a cardiorespiratory arrest and was resuscitated. AbbreviationsĪAS: Acute aortic syndrome IH: Intramural hematoma AD: Aortic dissection PU: Penetrating ulcer CT: Computed tomography RESA: Registro español de sindrome aortico (aortic syndrome spanish registry) Key wordsĪortic dissection, acute aortic syndrome, cardiac arrest, blood vessel, portal pneumatosis, intestinal ischemia HistoryĪn 81-year-old woman presented in Accident & Emergency in Marina Baixa Hospital, Villajoyosa, Alicante,complaining of severe abdominal pain for last two previous days and hypotension. We presented a case in imagen of acute aortic dissection and showed the most representative TC findings. It is recommended that the scanning field include the entire aorta and pelvic vessels to help determine the type and extent of dissection. Early diagnosis and treatment are essential for improving the prognosis. ![]() ![]() Aortic dissection is the most common acute emergency condition of the aorta. ![]()
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