RESUMEN
A 91-year-old African American man was admitted with sudden onset diffuse abdominal pain which radiated to the right flank. CT of the abdomen with contrast showed diverticula in the jejunum with adjacent inflammation and microperforation that was contained. Conservative therapy similar to colonic diverticulitis was effective. Although rare, our case highlights the importance of having an early and high suspicion for jejunal diverticulitis when patients present with non-specific abdominal symptoms in order to avoid perforation.
Asunto(s)
Tratamiento Conservador/métodos , Diverticulitis/terapia , Enfermedades del Yeyuno/terapia , Dolor Abdominal/etiología , Anciano de 80 o más Años , Diverticulitis/diagnóstico por imagen , Diagnóstico Precoz , Humanos , Enfermedades del Yeyuno/diagnóstico por imagen , Masculino , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Acute aortic dissection is associated with significant morbidity and mortality, often from complications including aortic regurgitation, cardiac tamponade and myocardial infarction. Typical clinical presentation includes a sudden onset of severe chest pain, although this is not always consistent. Clinical signs and symptoms are diverse with an estimated 38% of cases being missed on initial evaluation. Primary neurological symptoms at presentation are rare but have been reported often to coexist with chest pain. We present a case of acute aortic dissection in which the initial presenting symptoms were predominantly neurological. Stanford type A dissection is a surgical emergency with a high burden of cardiovascular death; thus, aggressive identification and management is paramount. Our case re-emphasises the importance of having a higher index of suspicion and a keen clinical eye for atypical presentations of acute aortic dissection.