A Case Report of Successful Treatment by Colectomy of Right Hemicolonic Necrosis Complicating Acute DeBakey Ⅲb Type Aortic Dissection

Abstract

The patient was a 73-year-old man who presented to our outpatient department with the chief complaints of low back pain and abdominal pain after eating. Chest-abdominal computed tomography（CT）showed a DeBakey Ⅲb type aortic dissection, and also a dissection in the superior mesenteric artery. There was no evidence of rupture, and the contrast of the intestinal wall was good, and the patient was admitted to hospital because of our policy of conservative treatment while ensuring that the blood pressure is well-controlled. On the 6th day after admission, the patient complained of right lower abdominal pain, and the findings of an abdominal CT at this time led to the suspicion of necrosis of the right colon, and emergency laparotomy was performed. The necrotic right colon was excised and a double gun colostomy was constructed. The postoperative course was uneventful and the patient was discharged 40 days after the operation. Intestinal necrosis complicating acute aortic dissection has a high mortality rate, and lifesaving is often difficult, even if surgery is performed. This case is reported here, along with some consideration of the relevant literature.