Revels Jonathan W, Wang Sherry S, Febbo Jennifer, Murali Sowmiya, Luft Kimberly
Department of Radiology, University of New Mexico, MSC 10 5530, Albuquerque, NM 87131, USA.
Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT.
Radiol Case Rep. 2020 Sep 22;15(11):2382-2384. doi: 10.1016/j.radcr.2020.09.025. eCollection 2020 Nov.
Pulmonary artery dissection is an exceedingly rare and highly lethal diagnosis that can result in arterial rupture; hence, it is most often identified postmortem. Moreover, pulmonary artery complications resulting from aortic dissection are uncommon occurrences that have seemingly only been reported in cases of Stanford type A aortic dissections. Due to the rarity of pulmonary artery dissections, there is no current established algorithm for treatment of these patients, unlike aortic dissections. We herein present a case of a 40-year-old male with history of uncontrolled hypertension who developed acute back and leg pain that was subsequently diagnosed with a Stanford type B aortic dissection that extended into the main pulmonary artery by way of the ductus arteriosus. Although the patient received appropriate care for his aortic dissection and hypertensive emergency, he eventually died due to development of extensive additional vascular insults: cerebrovascular accidents, compartment syndrome, and myocardial infarction. To our knowledge, this is the first case of combined pulmonary artery dissection and Stanford type B dissection in the literature, which unfortunately adds to the understanding that cases of pulmonary artery dissection tend to have a grim prognosis.
肺动脉夹层是一种极其罕见且致死率极高的病症，可导致动脉破裂；因此，它大多是在尸检时才被发现。此外，主动脉夹层引发的肺动脉并发症并不常见，似乎仅在斯坦福A型主动脉夹层病例中有所报道。由于肺动脉夹层十分罕见，目前尚无针对此类患者的既定治疗方案，这与主动脉夹层不同。我们在此报告一例40岁男性患者，有高血压控制不佳病史，突发急性背痛和腿痛，随后被诊断为斯坦福B型主动脉夹层，并通过动脉导管延伸至主肺动脉。尽管患者接受了针对主动脉夹层和高血压急症的恰当治疗，但最终因出现广泛的额外血管损伤：脑血管意外、骨筋膜室综合征和心肌梗死而死亡。据我们所知，这是文献中首例合并肺动脉夹层和斯坦福B型夹层的病例，不幸的是，这进一步加深了人们对肺动脉夹层病例往往预后不良的认识。
