Frequency of Acute aortic Syndromes and Other Thoracoabdominal Emergencies Detected by CT Angiography in Sudden Onset Chest Pain


GEZER N. S., BAŞARA AKIN I., BARIŞ M. M., GÜLCÜ A.

GAZI MEDICAL JOURNAL, cilt.28, sa.2, ss.85-89, 2017 (ESCI, Scopus, TRDizin) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 28 Sayı: 2
  • Basım Tarihi: 2017
  • Doi Numarası: 10.12996/gmj.2017.25
  • Dergi Adı: GAZI MEDICAL JOURNAL
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.85-89
  • Anahtar Kelimeler: Aorta, acute aortic syndrome, multidetector computed tomography angiography, dissection
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

Objective: Acute coronary syndrome and pulmonary thromboembolism (PTE) are the pathologies to be considered in the differential diagnosis of acute aortic syndromes (AAS). However, it is not uncommon many thoracoabdominal emergencies imitating AAS. In this study, we aimed to evaluate the results of computed tomography angiography (CTA) images obtained for sudden onset chest pain in the emergency department because of a preliminary diagnosis of AAS. Methods: We retrospectively evaluated the imaging archive of our hospital for images obtained for sudden onset chest pain in the emergency department because of initial diagnosis of AAS between January 2011 and July 2013. Detected AAS and acute thoracic and abdominal pathologies were recorded. Results: Out of 631 CTA, 152 (24.1%) demonstrated thoracoabdominal emergencies. 34 of them (5.4%) were AAS. A 27 (17.8%) of the AAS's were aortic dissection, while 7 (4.6%) of them were a ruptured aortic aneurysm. Thoracic and abdominal emergencies were detected in 79 (52%) and 26 (17.1%) of cases respectively. More common ones were pneumonia (30.3%), pulmonary edema (9.9%), PTE (9.2%), urinary obstruction secondary to nephrolithiasis (5.9%), mesenteric lymphadenitis (3.3%) and acute cholecystitis (3.3%). Urgent complications due to primary malignancies such as lung cancer, lymphoma and colon cancer were detected in 13 (8.6%) of the cases. Conclusion: In the current study, pneumonia, pulmonary edema, PTE, urinary obstruction secondary to nefrolitiasis, mesenteric lymphadenitis and acute cholecystitis were more commonly detected thoracoabdominal emergencies imitating AAS. Another remarkable finding was the frequency of urgent complications due to primary malignancies.