Acute aortic syndrome: a 'last glance' before incision.
Acute aortic syndrome (AAS) (aortic dissection, intramural aortic haematoma, or penetrating atherosclerotic ulcer) is a surgical emergency. Computed tomography (CT) is the reference technique for the diagnosis of this critical situation. However, a few reports of false-positive images leading to unnecessary interventions have been published. It is important to recognize and understand the pitfalls in the CT diagnosis of AAS. We describe the case of a 76-year-old man with clinical signs of AAS and a CT-scan compatible with a diagnosis of aortic intra-mural haematoma, leading to emergency surgery. The peroperative findings revealed a normal aortic wall with the presence of an unusual pericardial recess at the right side of the aorta.
Department of Thoracic and Cardiovascular Surgery, Rouen University Hospital, 1, rue de Germont, 76000 Rouen, France. guillaumelebreton@live.fr
Guillaume
G
Lebreton
Pierre-Yves
PY
Litzler
Jean-Paul
JP
Bessou
Fabien
F
Doguet
D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging* / Q000601:surgery; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery; D001018:Aortic Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D001027:Aortography / Q000379:methods*; D003951:Diagnostic Errors; D017548:Echocardiography, Transesophageal; D005189:False Positive Reactions; D006406:Hematoma / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D056346:Sternotomy; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D014456:Ulcer / Q000000981:diagnostic imaging* / Q000601:surgery; D019564:Unnecessary Procedures; D014656:Vascular Surgical Procedures