Fatal Case of Type A Aortic Dissection Presenting As Acute Renal Failure

Abstract

Fuat Ozkan, Mehmet Fatih Inci, Selim Bozkurt, Bulent Altunoluk, Hasan Kahraman, Murvet Yuksel

Aortic dissection is a life-threatening illness requiring early diagnosis and treatment. Uncommon early presentations mimicking various illnesses can delay diagnosis. Acute renal failure (ARF) is an uncommon complication of type A aortic dissection (AAD). Presentation with ARF is associated with an increased risk of in-hospital death and persistence of renal dysfunction at midterm follow-up in type B aortic dissection, but not AAD. We report a case of a type A aortic dissection complicated by ARF, with a fatal outcome. A 56-year-old male was transferred to the emergency service with anuria and rapid deterioration of renal function. Computed tomography showed type A aortic dissection with near-complete collapse of the true lumen at the level of the renal arteries and complicated with left renal infarct. Because of deterioration of his general condition during hemodialysis, he was treated with supportive measures including ventilatory support. He died two days after admission. Aortic dissection initially mimicking ARF is rare. Accurate early diagnosis of aortic dissection with indeterminate presentation is crucial.