Asymptomatic Acute Dissection of the Abdominal Aorta as a Rare Complication of Takayasu Disease

The present study describes a case of a 24-year-old who had an asymptomatic acute dissection of the abdominal sub-renal aorta along with an inflammatory syndrome suggestive of Takayasu disease. Aortic dissection is a rare complication of Takayasu's disease that has only been reported a few times in the literature. The type of aortic dissection (type III b, according to the classification of De Bakey and Stanford) confirmed by computed tomography scan of the aorta (CT scan) in our patient. The patient underwent conservative medical treatment.

A Case of Acute Type B Aortic Dissection Subsequent to Asymptomatic Chronic Type A Aortic Dissection Which Was Difficult to Distinguish from Acute Type A Aortic Dissection / 日本心臓血管外科学会雑誌

Aortic dissection presents with acute chest or back pain. However, it can be asymptomatic in the acute phase with delayed symptomatic presentation or incidental diagnosis upon chest imaging. We report a case of acute type B aortic dissection subsequent to chronic type A aortic dissection which was difficult to distinguish from acute type A aortic dissection. A 45-year-old man was admitted to a hospital with sudden back pain. An enhanced chest CT revealed a suspected acute type A aortic dissection. The patient was transferred to our hospital and we performed an emergent total arch replacement. Intraoperative findings showed that there were two entries at the origin of the brachiocephalic artery and the left subclavian artery. The ascending aorta presented wall thickening but the descending aorta did not present wall thickening. Histopathologically, the adventitia was obviously thickened with dissection findings in the tunica media. Thus it was diagnosed as acute type B aortic dissection subsequent to chronic type A aortic dissection. Great caution should be taken in asymptomatic chronic aortic dissection.