Tratamiento quirúrgico de la úlcera penetrante de aorta ascendente. Casos clínicos

Penetrating aortic ulcer (PAU) is an ulceration of an atherosclerotic plaque which disrupts the aortic internal elastic lamina and that can evolve to an intramural hematoma (IH), aortic dissection or aortic rupture. We report two cases with PAU. A 73 year-old woman with a history of hypertension, pr...

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Autores principales:	González L.,Roberto, Stockins L.,Aleck, Seguel S.,Enrique, Jadue T.,Andrés, Riquelme U.,Alejandra, Canales Z.,Jorge, Fuentes E.,Alberto, Alarcón C.,Emilio
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2017
Materias:	Aorta Aortic Diseases Thoracic Surgery
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017001101490
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spelling	oai:scielo:S0034-988720170011014902018-04-06Tratamiento quirúrgico de la úlcera penetrante de aorta ascendente. Casos clínicosGonzález L.,RobertoStockins L.,AleckSeguel S.,EnriqueJadue T.,AndrésRiquelme U.,AlejandraCanales Z.,JorgeFuentes E.,AlbertoAlarcón C.,Emilio Aorta Aortic Diseases Thoracic Surgery Penetrating aortic ulcer (PAU) is an ulceration of an atherosclerotic plaque which disrupts the aortic internal elastic lamina and that can evolve to an intramural hematoma (IH), aortic dissection or aortic rupture. We report two cases with PAU. A 73 year-old woman with a history of hypertension, presented with acute chest pain of three days of evolution and a hypertensive emergency. An electrocardiogram showed ST-segment elevation and elevated cardiac enzymes. Computed tomography (CT) scans showed an acute ascending aortic mural hematoma secondary to PAU and hemopericardium. Replacement of ascending aorta was performed with a vascular prosthesis with extracorporeal circulation (ECC). PAU and IH were confirmed by histopathology. A 62-year old woman with a history of hypertension, diabetes and chronic obstructive pulmonary disease, consulted for abdominal pain of two days of evolution. A thoracic-abdominal CT scan visualized an uncomplicated PAU and an abdominal aortic aneurysm. Because of abdominal pain and signs of peritoneal irritation, an exploratory laparotomy was performed finding a typhlitis. Resection and ileo-ascendo-anastomosis were performed. A new CT scan showed PAU with high risk of rupture without a clinical acute aortic syndrome. The patient was operated replacing the ascending aorta with a vascular prosthesis using ECC. Three PAU were found. Histopathology confirmed the diagnosis. Both patients evolved without postoperative complications.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.145 n.11 20172017-11-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017001101490es10.4067/s0034-98872017001101490
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Aorta Aortic Diseases Thoracic Surgery
spellingShingle	Aorta Aortic Diseases Thoracic Surgery González L.,Roberto Stockins L.,Aleck Seguel S.,Enrique Jadue T.,Andrés Riquelme U.,Alejandra Canales Z.,Jorge Fuentes E.,Alberto Alarcón C.,Emilio Tratamiento quirúrgico de la úlcera penetrante de aorta ascendente. Casos clínicos
description	Penetrating aortic ulcer (PAU) is an ulceration of an atherosclerotic plaque which disrupts the aortic internal elastic lamina and that can evolve to an intramural hematoma (IH), aortic dissection or aortic rupture. We report two cases with PAU. A 73 year-old woman with a history of hypertension, presented with acute chest pain of three days of evolution and a hypertensive emergency. An electrocardiogram showed ST-segment elevation and elevated cardiac enzymes. Computed tomography (CT) scans showed an acute ascending aortic mural hematoma secondary to PAU and hemopericardium. Replacement of ascending aorta was performed with a vascular prosthesis with extracorporeal circulation (ECC). PAU and IH were confirmed by histopathology. A 62-year old woman with a history of hypertension, diabetes and chronic obstructive pulmonary disease, consulted for abdominal pain of two days of evolution. A thoracic-abdominal CT scan visualized an uncomplicated PAU and an abdominal aortic aneurysm. Because of abdominal pain and signs of peritoneal irritation, an exploratory laparotomy was performed finding a typhlitis. Resection and ileo-ascendo-anastomosis were performed. A new CT scan showed PAU with high risk of rupture without a clinical acute aortic syndrome. The patient was operated replacing the ascending aorta with a vascular prosthesis using ECC. Three PAU were found. Histopathology confirmed the diagnosis. Both patients evolved without postoperative complications.
author	González L.,Roberto Stockins L.,Aleck Seguel S.,Enrique Jadue T.,Andrés Riquelme U.,Alejandra Canales Z.,Jorge Fuentes E.,Alberto Alarcón C.,Emilio
author_facet	González L.,Roberto Stockins L.,Aleck Seguel S.,Enrique Jadue T.,Andrés Riquelme U.,Alejandra Canales Z.,Jorge Fuentes E.,Alberto Alarcón C.,Emilio
author_sort	González L.,Roberto
title	Tratamiento quirúrgico de la úlcera penetrante de aorta ascendente. Casos clínicos
title_short	Tratamiento quirúrgico de la úlcera penetrante de aorta ascendente. Casos clínicos
title_full	Tratamiento quirúrgico de la úlcera penetrante de aorta ascendente. Casos clínicos
title_fullStr	Tratamiento quirúrgico de la úlcera penetrante de aorta ascendente. Casos clínicos
title_full_unstemmed	Tratamiento quirúrgico de la úlcera penetrante de aorta ascendente. Casos clínicos
title_sort	tratamiento quirúrgico de la úlcera penetrante de aorta ascendente. casos clínicos
publisher	Sociedad Médica de Santiago
publishDate	2017
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017001101490
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Tratamiento quirúrgico de la úlcera penetrante de aorta ascendente. Casos clínicos

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