Clinical Analysis Of Aortic Dissection Presented With Abdominal Pain As Chief Symptom

OBJECTIVE:In order to improve the clinical experience of diagnosis and management of aortic dissection (AD), this study summarized the clinical features of AD whereas abdominal pain is the chief presenting symptom.METHODS:A retrospective analysis was carried out in fifty-one series patients with AD who were admitted to the First Affiliated Hospital of GuangXi Medical University. Patients were divided into type A and type B categories according to the Stanford classification system. We also compared and analyzed the history characteristics, diagnostic techniques and prognosis of the patients with the two categories.RESULTS:There was significant difference between the incidence of abdominal pain in Stanford Type B and Stanford Type A (P<0.05). The detective rate of AD by X-ray, TTE, Abdominal ultrasound, CTA, DSA and MRI were 78.3%(16/23),86.7%(26/30),75.0%(3/4),100%(49/49),100%(12/12) and 100%(5/5) respectively. The differential rate of AD by X-ray, TTE, Abdominal ultrasound, CTA, DSA and MRI ultrasound were 0,76.9%(20/26),33.3%(1/3), 87.8%(43/49),91%(11/12),100%(5/5) respectively. Abdominal pain as main symptoms of AD included 18 cases, of which three cases (16.6%) were died. Meanwhile, non-abdominal pain as the main symptoms of 33 patients with AD, of which seven patients were died (21.2%). As a result, there was no significant difference in mortality between abdominal pain as main symptoms of AD mortality and non-abdominal pain as main symptoms of AD (P>0.05). There are 33 cases AD patients with drug therapy, of which 28 cases were improving (84.8%). Eight cases were treated with interventional therapy, of which six cases were improving (75%). Ten cases were treated with surgical operation, of which seven cases were improving (70%). As a result, there was no significant difference in curative effect between these three treatment methods(P>0.05). The three groups had no statistical significance was detected (P>0.05). The incidence of hypertension in patients with AD (66.7%,34/51) was higher than the control (33.3%,17/51) (P<0.05). the increase of systolic blood pressure is significant (P＜0.05), while the difference between the diastolic blood pressure didn't make too much sense (P> 0.05).CONCLUSIONS:Abdominal pain was more commonly symptom in patients with Stanford Type B of AD as compare to Stanford Type A of AD. TTE is better than other radiographic techniques for early diagnosis of AD, which may have excellent potential as a first-line examination for AD diagnosing. Additionally, the mortality rate was not increased in aortic dissected patients whose chief symptom was abdominal pain. Medical treatment is still an important treatment for AD. AD easily occurs in patients with hypertension, therefore it is necessary for long-term effective blood pressure control.