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August 21, 2002

Clinical Manifestations of Acute Aortic Dissection

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;288(7):828. doi:10.1001/jama.288.7.828

To the Editor: In his article about the diagnosis of the acute aortic dissection, Dr Klompas1 describes some of the complications that result from occlusion of major arteries originating from the aorta including cardiac, neurologic, renal, and limb syndromes. He does not mention, however, that acute aortic dissection may also compromise the mesenteric artery. In a retrospective review of peripheral vascular complications of aortic dissection, of the 28% of patients with aortic branch occlusion, 20% had mesenteric malperfusion, which was associated with a 36% mortality rate.2 There are also several case reports that describe presentations of acute aortic dissection with mesenteric compromise, including abdominal pain, hematochezia, melena, and obstructive jaundice.35

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