Aortic dissection with ischemia of the abdominal organs

Abdominal organ ischemia associated with aortic dissection is a serious problem, although its incidence is not so high. In particular, the prognosis of bowel ischemia is extremely poor, especially, in cases with the diagnosis delayed and with extensive bowel ischemia. Consequently, 1st it should be suspected, in cases with abdominal pain or distension associated with acute or chronic aortic dissection. Then, its pathology should be assessed quickly with enhanced computed tomography (CT) or ultrasound examination to clarify the mechanism of critical organ ischemia including dynamic obstruction or static obstruction of the visceral arteries. According to the mechanism of abdominal organ ischemia, the best treatment of catheter interventions such as catheter fenestration, endovascular aortic repair, and branch-stenting, or of conventional open surgery such as surgical abdominal aortic fenestration, graft replacement, and branch-bypass should be appropriately chosen without delay.