title: An extensive DeBakey type IIIb aortic dissection with massive right pleural effusion presenting as abdominal pain and acute anemia: particular case report.
abstract: We describe the case of a 79-year-old male presented with sudden onset of abdominal pain and mild breathlessness, and complicated acute progressive anemia with haemoglobin which declined from 120 g/L to 70 g/L within five days. An urgent computed tomography angiography showed acute thoracic aortic dissection, DeBakey type IIIb, a dissecting aneurysm in the proximal descending thoracic aorta starting immediately after the origin of the left subclavian artery and extending distally below the renal arteries with evidence of rupture into the right pleural cavity for massive pleural effusion. Plasma D-dimer, brain natriuretic peptide and C reactive protein level were elevated. Our case showed that D-dimer can be used as a 'rule-out' test in patients with suspected aortic dissection. A raised BNP may exert a protective role through anti-inflammatory endothelial actions in the systemic circulation.
authors.affiliation: Department of Gerontology, Xiqing Hospital, Tianjin, China.
authors.forename: Hui-Chun
authors.initials: HC
authors.lastname: Yu
authors.affiliation: Department of Gerontology, Xiqing Hospital, Tianjin, China.
authors.forename: Zhen-Qing
authors.initials: ZQ
authors.lastname: Wang
authors.affiliation: Department of Gerontology, Xiqing Hospital, Tianjin, China.
authors.forename: Yuan-Yuan
authors.initials: YY
authors.lastname: Hao
authors.affiliation: Department of Gerontology, Xiqing Hospital, Tianjin, China.
authors.forename: Feng-Ping
authors.initials: FP
authors.lastname: An
authors.affiliation: Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, China.
authors.forename: Yu-Chuan
authors.initials: YC
authors.lastname: Hu
authors.affiliation: Cardiovascular Division of Gerontology, Pingjin Hospital, Logistic University of CAPF, Tianjin, China.
authors.forename: Rui-Bing
authors.initials: RB
authors.lastname: Deng
authors.affiliation: Cardiovascular Division of Gerontology, Pingjin Hospital, Logistic University of CAPF, Tianjin, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Yu
authors.affiliation: Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, China.
authors.forename: Guang-Bin
authors.initials: GB
authors.lastname: Cui
authors.affiliation: Cardiovascular Division of Gerontology, Pingjin Hospital, Logistic University of CAPF, Tianjin, China.
authors.forename: He
authors.initials: H
authors.lastname: Li
keywords: Acute aortic dissection; Anemia; D-dimer; The elderly