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Spontaneous dissection of the infrarenal aorta

The rupture of the intimal layer marks the beginning of the aortic dissection, which usually happens in the thoracic aorta. The spontaneous dissection of the infrarenal aorta is rare. The main causes are: iatrogenic, traumatic and spontaneous. Abdominal pain and limb ischemia are the commonest symptoms, and some patients are asymptomatics. The diagnosis is made by ultrasound, computed tomography, nuclear magnetic resonance and angiography, with a high suspicious index. We describe two cases of spontaneous rupture of the infrarenal aorta that were treated surgically. We report two cases of patients who were admitted to the emergency room of Celso Pierro Hospital with infrarenal abdominal aortic dissection and were treated by the vascular surgery group. They have presented sudden abdominal pain, no signs of peritoneal irritation and pulses were presents and simmetrics in physical examination The two patients during the examination were hypertensive and the ultrasound showed abnormal compliance of the abdominal aorta who were treated surgically. One patient was treated surgically with dissected plaque endarterectomy of infrarenal abdominal aorta of 2.2 cm in diameter and 2.0 cm in length. The other patient underwent revascularization of the abdominal aorta with bi-iliac Dacron graft 16 × 8 mm due to distal abdominal aortic dissection. Both patients had good postoperative evolution and they were discharged in good general condition.

dissection; aorta, abdominal; atherosclerosis


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