CTICasesType B Aortic Dissection with True Lumen Compression and Abdominal Ischemia
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Imaging findings
CT abdomen showed diffuse aortic abnormality with a severe type B aortic dissection (originating after the left subclavian artery). The true lumen was severely compressed by the false lumen. Despite severe symptoms (bloody bowel movements), the bowel loops themselves did not look overtly abnormal or thickened on the abdominal CT.
Key takeaways
This case highlighted an emergent, life-threatening situation: a type B aortic dissection with severe true lumen compression, leading to abdominal ischemia (evidenced by bloody bowel movements). It's crucial for residents to recognize that severe true lumen compression in dissection, even without overt bowel wall abnormalities on CT, can cause significant ischemia. Medical management is insufficient; emergent intervention (stenting to buttress open the true lumen proximally) is required. Improving flow upstream can restore distal perfusion.
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