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Spondylolisthesis mimicking the progression of dissection in a case of chronic Stanford type B aortic dissection

Aortic dissection is an acute lethal cardiovascular condition. A 67-year-old hypertensive woman was admitted to our Emergency Department with an abrupt onset of tearing pain in the interscapular area. A thoracic computed tomography scan with contrast showed chronic type B aortic dissection. The patient was transferred to intensive care and medical therapy was initiated. Upon spread of the pain to the lumbar area, the dissection was thought to have progressed. The patient, being hemodynamically stable, was examined using ultrasonography, and the dissection did not show any progression. In the neurological examination for the lumbar pain, the lumbar processus spinosus was found to be sensitive, and the sciatic nerve stretch test was positive at 30 degrees. Magnetic resonance imaging revealed spondylolisthesis and a centrally located disc herniation at the L3-4 level. No operation for the dissection was planned, but discectomy and fusion surgery was scheduled. Since the patient refused surgery, she was discharged with medical therapy. Our aim in this report was to emphasize the importance of spondylolisthesis mimicking the progression of dissection in the differential diagnosis of a chronic type B aortic dissection case

Keywords : Aged,Aneurysm,Dissecting,Aortic Aneurysm,Thoracic,complications,diagnosis,Diagnosis,Differential,diagnostic imaging,Dissection,etiology,Female,Humans,Intervertebral Disc Degeneration,Low Back Pain,Lumbar Vertebrae,Magnetic Resonance Imaging,Pain,Sciatic Nerve,Spondylolisthesis,surgery,therapy,Tomography,X-Ray Computed,Turkey,Ultrasonography,Universities,, Mimicking,Progression,Dissection, massage sciatica pain london

Date of Publication : 2011 Sep

Authors : Goz M;Torun MF;Mordeniz C;Aydin MS;Demirkol AH;Karabag H;

Organisation : Department of Cardiovascular Surgery, Harran University Faculty of Medicine, Sanliurfa, Turkey. mustafagoz@harran.edu.tr

Journal of Publication : Ulus Travma Acil Cerrahi Derg

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/22090335

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