Bruce R. Leslie, MD; Lionel H. Head, MD; John C. Scharfenberg, MD
To the Editor: The diagnosis of aortic dissection may be complicated by a patient's unusual presentation ( 1 ). We report a case of aortic dissection in which the most prominent abnormalities were due to hepatic ischemia.
A 5 3-year-old man was hospitalized for nausea and repetitive vomiting of sudden onset that were followed by dull periumbilical pain. His blood pressure was 240/130 mm Hg, and he had epigastric, periumbilical, and right upper quadrant abdominal tenderness. The aspartate aminotransferase level was 1220 U/L; alanine aminotransferase, 1502 U/L; lactate dehydrogenase, 2626 U/L; alkaline phosphatase, 66 U/L; and total bilirubin, 14 µmol/L.
Leslie BR, Head LH, Scharfenberg JC. Ischemic Hepatitis from Aortic Dissection. Ann Intern Med. ;110:495. doi: 10.7326/0003-4819-110-6-495_1
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Published: Ann Intern Med. 1989;110(6):495.
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