Acute aortic dissection presenting with primarily abdominal pain: A rare manifestation of a deadly disease

Gilbert R. Upchurch, Christoph Nienaber, Rossella Fattori, Arturo Evangelista, Jae Kuen Oh, Jeanna V. Cooper, Eric Isselbacher, Toru Suzuki, Kim A. Eagle

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

The objective of this study was to determine the morbidity and mortality of patients with acute thoracic aortic dissections who present primarily with abdominal pain. Nine hundred ninety-two patients (mean age, 62.1 years∈±∈14.1; 68% male) encountered from 1996 to 2001 with acute thoracic aortic dissections from the International Registry of acute Aortic Dissection were studied. Patient demographics, presenting symptoms, signs of aortic dissection, aortic pathology, and mortality were compared in patients presenting primarily with abdominal pain (group I, 46 patients, 4.6%) versus all others (group II). Demographics were similar between the two groups. When signs of aortic dissection were examined, 63% of patients in group I presented with hypertension compared to only 47% of patients in group II (p∈=∈0.04). Patients in group I were less likely to present with evidence of end-organ malperfusion. Importantly, mortality in patients with a type B dissection, specifically following surgery for the dissection, was significantly increased in patients who presented primarily with abdominal pain (group I, 28% mortality vs. group II, 10.2% mortality; p∈=∈0.02). This study documented increased mortality in patients with acute thoracic aortic dissections who present primarily with abdominal pain, underscoring the importance of maintaining a high index of suspicion for an aortic dissection in patients who have appropriate risk factors.

Original languageEnglish (US)
Pages (from-to)367-373
Number of pages7
JournalAnnals of Vascular Surgery
Volume19
Issue number3
DOIs
StatePublished - May 2005

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Upchurch, G. R., Nienaber, C., Fattori, R., Evangelista, A., Oh, J. K., Cooper, J. V., Isselbacher, E., Suzuki, T., & Eagle, K. A. (2005). Acute aortic dissection presenting with primarily abdominal pain: A rare manifestation of a deadly disease. Annals of Vascular Surgery, 19(3), 367-373. https://doi.org/10.1007/s10016-004-0171-x