DeBakey Type III Aortic Dissection Causing Bowel Necrosis: A Case Report  

作　　者：Jinhu Kong Jiazheng Li Haiyang Hu Shangyun Pan Hongsheng Liu 

机构地区：[1]Clinical Medical College of Jining Medical University,Jining 272067,Shandong Province,China [2]Department of Cardiac Intensive Medicine,Affiliated Hospital of Jining Medical University,Jining 272000,Shandong Province,China

出　　处：《Journal of Clinical and Nursing Research》2024年第8期159-162,共4页临床护理研究（英文）

基　　金：Jining City Key R&D Program Projects(Project No.:2023YXNS155)。

摘　　要：Rationale:Aortic dissection is a life-threatening medical emergency associated with high morbidity and mortality.Preoperative mesenteric malperfusion increases the surgical risk and mortality in patients with type B aortic dissection.For DeBakey type III B patients involving most of the thoracoabdominal aorta,endovascular treatment to improve true lumen perfusion may have limited benefits.Organ reperfusion on-time is crucial.Patient concerns:A 38-year-old man was admitted with sudden severe upper abdominal pain.Emergency CTA of the entire aorta revealed an aortic dissection with an entry tear in the descending aortic arch involving the celiac trunk,superior mesenteric artery,bilateral common iliac arteries and right external iliac artery,with thrombosis in the superior mesenteric artery.Diagnoses:The patient was diagnosed with DeBakey type III aortic dissection with mesenteric artery embolism.Enhanced chest CT showed the entry tear location and involvement of major arteries.Angiography confirmed partial blood flow in the superior mesenteric artery.Interventions:The patient underwent endovascular aortic stent-graft implantation through the left femoral artery,covering the descending aortic arch and sealing the entry tear.Postoperatively,the patient received intensive care,including ventilatory support,CRRT,anti-infection therapy,vasoactive drugs and lumbar cistern drainage.Outcomes:Two weeks postoperatively,the patient developed massive black stools,indicative of intestinal obstruction and necrosis.Exploratory laparotomy revealed ischemic necrosis and rupture of the stomach,small intestine,and colon.Despite surgical efforts,the patient’s condition deteriorated,leading to death from severe infection,acid-base imbalance and multiple organ failure.

关 键 词：Abdominal pain Aortic dissection Arterial embolism Mesenteric artery 

分 类 号：R54[医药卫生—心血管疾病]