title: Complete regression of an intramural hematoma of the aorta after distal reperfusion.
abstract: A 58-year-old man with hypertension, severe abdominal pain, and pulseless extremities was diagnosed with an isolated abdominal intramural hematoma (IMH). The IMH extended from the distal descending thoracic aorta to just proximal to the renal arteries. beta-Blockade treatment resolved the abdominal pain but induced progressive oliguria; decreasing beta-blockade treatment increased urine output but caused return of abdominal pain. An axillobifemoral bypass allowed distal perfusion and retrograde visceral artery perfusion while maintaining normal blood pressure. The abdominal pain resolved, urine output increased, and the patient was discharged on day 7. Six months later the patient required an emergent thrombectomy of the axillobifemoral graft and normal antegrade aortic flow was found. A computed tomography scan showed resolution of the IMH.
authors: Division of Cardiothoracic Surgery, Virginia Commonwealth University Medical Center, 23298, USA. adeanda@vcu.edu
authors: Abe
authors: A
authors: Deanda
authors: Vigneshwar
authors: V
authors: Kasirajan
authors: Daniel
authors: D
authors: Henry
authors: Stuart I
authors: SI
authors: Myers
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D001366:Axillary Artery / Q000637:transplantation; D003404:Creatinine / Q000097:blood; D005263:Femoral Artery / Q000601:surgery; D006083:Graft Occlusion, Vascular / Q000601:surgery; D006406:Hematoma / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012075:Remission, Spontaneous; D017131:Thrombectomy; D014057:Tomography, X-Ray Computed
chemical_list: D003404:Creatinine