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青年患者因广泛主动脉夹层导致死亡,夹层罕见逆行扩展。

Death due to extensive aortic dissection with an unusual retrograde extension in a young adult.

机构信息

Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

Department of Forensic Medicine and Toxicology, Dr Sampurnanand Medical College, Jodhpur, India.

出版信息

J Forensic Leg Med. 2022 Nov;92:102437. doi: 10.1016/j.jflm.2022.102437. Epub 2022 Oct 5.

Abstract

Aortic dissection usually manifests in older individuals. It is a rare cause of sudden death in the age group <35 years. Compared to older age groups, this age range is likely to have distinct clinical and pathologic features, uncommon risk factors, and an unusual presentation. This case reports the sudden death of a 34-year-old male due to extensive aortic dissection without any previously known predisposing factors. Autopsy examination showed the presence of aortic dissection with the formation of the false lumen, which extended from the root of the aorta to the whole length of the ascending aorta, arch of the aorta and further up to 27 cm length of the descending aorta. The pathological examination also revealed retrograde involvement of the brachiocephalic artery and left common carotid artery. The reported AD belonged to Stanford 'type A'. Such extensive AD with unique retrograde extension is rarely reported in Forensic Pathology literature.

摘要

主动脉夹层通常发生在老年人中。它是 35 岁以下人群中突然死亡的罕见原因。与老年人群相比,这个年龄段可能具有明显的临床和病理特征、不常见的危险因素和不常见的表现。本病例报告了一例 34 岁男性因广泛主动脉夹层导致的猝死,此前无任何已知的易患因素。尸检显示主动脉夹层形成假腔,从主动脉根部延伸至升主动脉、主动脉弓全长,并进一步向上延伸至 27 厘米长的降主动脉。病理检查还显示头臂动脉和左颈总动脉逆行受累。报告的 AD 属于斯坦福“A型”。法医病理学文献中很少有如此广泛的 AD 伴有独特的逆行延伸。

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