Dickens P, Khoo U S
Department of Pathology, University of Hong Kong.
Forensic Sci Int. 1993 May;59(2):149-55. doi: 10.1016/0379-0738(93)90153-2.
We report a case of rapidly fatal aortic dissection which was unusual because no intimal tear was present and no blood was present in the dissected aortic wall, although the dissection involved the entire aorta. Death was considered to be due to acute myocardial ischaemia from dissection involving the left coronary artery. Prominent cystic medial necrosis was present. There was no history of hypertension and only histological evidence of left ventricular hypertrophy. No other clinical or pathologic states associated with aortic dissection were present. Although cystic medionecrosis was the probable cause in this case, it is present in only a small proportion of patients in the absence of Marfan's syndrome, and more recently investigated defects in the composition of aortic wall connective tissue components may be more relevant factors in the causation of many cases of aortic dissection.
我们报告一例迅速致死的主动脉夹层病例，该病例不同寻常，因为尽管夹层累及整个主动脉，但未发现内膜撕裂，且夹层主动脉壁内无血液。死亡被认为是由于累及左冠状动脉的夹层导致急性心肌缺血所致。存在显著的囊性中层坏死。无高血压病史，仅有左心室肥厚的组织学证据。不存在与主动脉夹层相关的其他临床或病理状态。尽管囊性中层坏死可能是该病例的病因，但在没有马凡综合征的情况下，仅一小部分患者存在这种情况，并且最近对主动脉壁结缔组织成分组成缺陷的研究可能是许多主动脉夹层病例病因中更相关的因素。
