Spontaneous isolated dissection of the abdominal aorta.

Isolated spontaneous dissection of the abdominal aorta is such a rare entity and there are only a few cases reported in literature up to date. A 42-year old male was admitted to the hospital with mild pain in the lower abdomen and back that had began seven days prior to admission together with the sudden onset of the ischemic symptoms of the left leg (ischemic ulcers of the calf gangrenous toe and pallor foot). Patient denied any trauma, hypertension history was negative, while he was active cigarette smoker. MSCT and digital subtracted angiography have shown a dissection of the abdominal aorta approximately two centimeters below the origin of the inferior mesenteric artery extending in the left common iliac artery, with no sign of the aneurysmatic dilatation of the abdominal aorta. Emergent surgery was performed with aorto-biiliacal bypass graft interposition, amputation of the left toe and necrectomy of the left calf Postoperative follow up and local vascular condition were satisfied. Even though is rare entity, isolated abdominal aorta dissection accounts for approximately 2-4% of all aortic dissection. Nowadays therapeutic regimen includes endovascular, open surgery or conservative treatment.