Bad Japanese Food?
This week’s image of the week is brought to you by Dr. Ricardo Martinez and Dr. John Lemos.
The images are of an ascending aortic dissection that was discovered in a 46 year-old male who presented with atypical symptoms. The patient's chief complaint was 3 weeks of upper and lower back pain (which he blamed on recent low speed motor vehicle collision) and nausea/vomiting from “bad Japanese food”. He had a history of HTN and a family history of CAD at an early age in his father. Upon presentation, he had normal vital signs and an unremarkable physical exam. A urinalysis that showed RBCs prompted the treatment team to order a CT non-contrast of the abdomen and pelvis, which was interpreted as suspicious for dissection of the aorta. The diagnosis was confirmed at the bedside using ultrasound and the patient subsequently underwent a CT with contrast and was admitted for emergent surgical repair. This case serves to remind us that keeping an open mind when forming one’s differential diagnosis is essential!
Sagittal
Transverse
The images are of an ascending aortic dissection that was discovered in a 46 year-old male who presented with atypical symptoms. The patient's chief complaint was 3 weeks of upper and lower back pain (which he blamed on recent low speed motor vehicle collision) and nausea/vomiting from “bad Japanese food”. He had a history of HTN and a family history of CAD at an early age in his father. Upon presentation, he had normal vital signs and an unremarkable physical exam. A urinalysis that showed RBCs prompted the treatment team to order a CT non-contrast of the abdomen and pelvis, which was interpreted as suspicious for dissection of the aorta. The diagnosis was confirmed at the bedside using ultrasound and the patient subsequently underwent a CT with contrast and was admitted for emergent surgical repair. This case serves to remind us that keeping an open mind when forming one’s differential diagnosis is essential!
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