[Thoracic dissecting aortic aneurysm. Contribution to the differential diagnosis of increased enzymes indicating cholestasis, fever and thoracic pain].
A 68 years old female patient was admitted with thoracic pain and fever (40.0 degrees C). A coronary heart disease was known. The liver was enlarged, the cholestatic enzymes elevated without bilirubinaemia. In the blood culture gram-negative bacilli was found. Our diagnosis: septic cholangitis, coronary ischemia. She was better by antibiotic therapy, the fever fell. Few days later she suddenly died. Autopsy demonstrated a serious arteriosclerosis of the aorta, an aneurysm on the aortic arc with chronic bleeding in the environmental tissue with inflammation and coronary arteriosclerosis. The liver was normal.
D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood*; D000784:Aortic Dissection / Q000473:pathology*; D001013:Aorta, Thoracic / Q000473:pathology; D001014:Aortic Aneurysm / Q000473:pathology*; D001019:Aortic Rupture / Q000473:pathology; D001161:Arteriosclerosis / Q000473:pathology; D001651:Cholestasis, Extrahepatic / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D005335:Fever of Unknown Origin / Q000473:pathology*; D006801:Humans; D005723:gamma-Glutamyltransferase / Q000097:blood*
D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase
Thorakales disseziierendes Aortenaneurysma. Beitrag zur Differentialdiagnose von erhöhten, eine Cholestase anzeigenden Enzymen, Fieber und thorakalen Schmerzen.