Isolated Abdominal Pain as a Sole Presentation of Type B Aortic Dissection in a Young Female: A Case Report

Abstract

Aortic dissection is a rare but life-threatening emergency that often presents with chest pain. However, atypical presentations may delay diagnosis, particularly in younger patients. We report a case of a 37-year-old hypertensive female who presented with isolated abdominal pain. Bedside ultrasound revealed a double lumen sign, and CT angiography confirmed a Stanford type B (DeBakey IIIb) aortic dissection extending to the iliac bifurcation, with involvement of visceral arteries and a renal infarction. The patient was managed conservatively with intravenous antihypertensives but declined further imaging or surgical intervention due to financial limitations and was discharged against medical advice. This case highlights the importance of clinical suspicion in atypical presentations and the utility of point-of-care ultrasound for early detection. CT angiography remains the gold standard for diagnosis. While conservative management is appropriate for uncomplicated type B dissections, ischemic complications such as renal infarction often warrant endovascular repair. Socioeconomic barriers significantly impacted this patient’s care and prognosis. Aortic dissection may present atypically and requires a high index of suspicion for prompt diagnosis. Equitable access to advanced diagnostics and interventions is crucial to improving outcomes, especially in younger patients with limited resources.