Diseksi Aorta Akut Stanford Tipe B dengan Gejala Akut Abdomen

Penulis

  • Ni Luh Putu Rustiari Dewi Fakultas Kedokteran Universitas Udayana, Denpasar, Indonesia
  • IGM Ardika Aryasa Fakultas Kedokteran Universitas Udayana,Denpasar, Indonesia
  • Kadek Susila Surya Dharma Dokter Spesialis Jantung dan Pembuluh Darah, RSUP Sanglah, Denpasar, Indonesia

DOI:

https://doi.org/10.55175/cdk.v46i2.509

Kata Kunci:

Akut abdomen, diseksi aorta, Stanford tipe B

Abstrak

Diseksi aorta akut merupakan kegawatdaruratan aorta dengan presentasi klinis tidak spesifik dan mortalitas tinggi, terutama bila tidak dikenali dini menyebabkan penanganan terlambat di unit gawat darurat. Sebuah kasus pada laki-laki usia 71 tahun dengan diseksi aorta Stanford tipe B dengan presentasi atipik, yaitu gejala nyeri abdomen akut. Pasien memiliki riwayat hipertensi tidak terkontrol sejak satu tahun. CT Angiography menunjukkan gambaran diseksi aorta Stanford tipe B dari arteri subclavia menurun hingga setinggi percabangan aorta. Terapi awal berupa kontrol tekanan darah. Selanjutnya pasien dirujuk untuk terapi thoracic endovascular aortic repair (TEVAR). Gejala akut abdomen perlu dipertimbangkan sebagai salah satu gejala klinis diseksi aorta.

Acute aortic dissection is an emergency aortic disease with unspecific clinical presentations and high mortality especially if not early recognized. Its unspecific clinical presentations contribute to lack of proper initial emergency treatment. A case of 71 year-old male with Stanford type B aortic dissection with atypical presentation of acute abdomen was reported. Patient had uncontrolled hypertension since one year ago. CT Angiography described Stanford type B aortic dissection with dissection flap seen just beyond the origin of left subclavian artery extending downwards to terminate just above aortic bifurcation. Initial treatment was pain management and blood pressure control. Tha patient was referred for thoracic endovascular aortic repair (TEVAR). Acute abdomen must be considered as one of clinical presentations of acute aortic dissection.

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Referensi

Cohen R, Mena D, Carbajal-Mendoza R, Arole O, Mejia JO. A case report on asymptomatic ascending aortic dissection. Int J Angiol 2008;17(3):155-61

Olsson C, Thelin S, Stahle E, Ekbom A, Granath F. Thoracic aortic aneurysm and dissection: increasing prevalence and improved outcomes reported in a nationwide population-based study of more than 14 000 cases from 1987 to 2002. Circulation 2006;114:2611-8

Hiratzka LF, Bakris GL, Beckman JA, et al. The American College of Cardiology Foundation and the American Heart Association 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the diagnosis and management of patients with thoracic aortic disease. J Am Coll Cardiol .55(14):e58-e74

Thrumurthy SG, Karthikesalingam A, Paterson BO, Holt PJE, Thompson MM. The diagnosis and management of aortic dissection. BMJ 2012;344:d8290

Von Kodolitsch Y, Schwartz AG, Nienaber CA. Clinical prediction of acute aortic dissection. Arch Intern Med 2000;160:2977-82

Bergmark BA, Sobieszczyk P, Gravereaux EC, Bonaca M, Giugliano RP. Acute Dissection of the Descending Aorta: A CaseReport and Review of the Literature. Cardiol Ther 2013;2:199–213

Lo Chi-Hung, Chen C, Hsueh C,Feng C. Aortic Dissection Mimics Acute Abdomen in an Older Patient. Internat J Gerontol 2012;6:140-3

Erbel R, Victor A, Catherine B, et al. ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adul. 2014.Eurheartj: Germany

Marbun JMH. Diseksi Aorta: Kegawatdaruratan Kardiovaskular. CDK 2016; 43(12):891-4

Upchurch GR Jr, Nienaber C, Fattori R, et al. Acute aortic dissection presenting with primarily abdominal pain: a rare manifestation of a deadly disease. AnnVasc Surg. 2005;19:367e373

Lay C-S, Yu C-J, Tyan Y-S.Abdominal Aortic Dissection with Acute Mesenteric Ischemia in a Patient with Marfan Syndrome. J Chin Med Assoc. 2006;69(7):326-9

Hung LC, Chang CC, Wen HC. Aortic Dissection Mimics Acute Abdomen in an Older Patient. Internat J Gerontol. 2012;6:140-3

Grabenwoger M, Alfonso F, Bachet J, Bonser R, Czerny M, et al. Thoracic Endovascular Aortic Repair (TEVAR) for the treatment of aortic diseases: a position statement from the European Association for Cardiology (ESC), in collaboration with the Europian Association of Percutaneuos Cardiovascular Interventions (EAPCI). Eur Heart J 2012;33(13): 1558-66

Peneault J, Oiment D, et al. A case of an aortic dissection in a young adult: a refresher of the literature of this “great masquerader”. Internat J Gen Med 2011; 4: 889–893

Morais H, Manuel V, Caceres-Loriga FM. Misdiagnosis of acute aortic dissection: Case report. J Integr Cardiol. 2016;2(4): 322-32

Yuan S, Tager S. Acute onset of chronic aortic dissection presenting as abdominal pain.Kardiologia Polska 2009; 67: 2

Erbel R, Alfonso F, Boileau C, Dirsch O, Eber B, Haverich A, et al. Diagnosis and management of aortic dissection. Eur Heart J 2001;22:1642-81

Toru S, Kim A, Eagle E, Bossone A, Ballotta JB, Froehlich EM, Isselbacher. Ann Cardiothorac Surg. 2014;3(4):413-7

Hony JB, Nabeela Z, Graham DC, Roland W, Darlington OO, Darrel P.F. Systematic review of genuine versus spurious side-effects of beta-blockers in heart failure using placebo control: Recommendations for patient information.Int J Cardiol. 2013 Oct 9; 168(4): 3572–3579

Fabelli F, Dake MD. Standard of Practice for the Endovascular Treatment of Thoracic Aortic Aneurysms and Type B Dissections. Cardiovasc Intervent Radiol 2009;32:849–860

Diterbitkan

2019-02-01

Cara Mengutip

Rustiari Dewi, N. L. P., Aryasa, I. A., & Surya Dharma, K. S. (2019). Diseksi Aorta Akut Stanford Tipe B dengan Gejala Akut Abdomen. Cermin Dunia Kedokteran, 46(2), 117–120. https://doi.org/10.55175/cdk.v46i2.509

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