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.
Lebreton
Guillaume
G
Department of Thoracic and Cardiovascular Surgery, Rouen University Hospital, 1, rue de Germont, 76000 Rouen, France. guillaumelebreton@live.fr
Litzler
Pierre-Yves
PY
Bessou
Jean-Paul
JP
Doguet
Fabien
F
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